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Home , Aceclidine, Allylestrenol, Barbiturate, Benzobarbital, Butamirate, Carbaldrate

Pharmacology on your palms CLASSIFICATION OF THE

DRUGS FROM DRUGS AFFECTING THE ORGANS CHEMOTHERAPEUTIC DIFFERENT DRUGS AFFECTING THE AND TISSUES DRUGS PHARMACOLOGICAL GROUPS Drugs affecting peripheral Antitumor drugs Drugs affecting the cardiovascular , antiviral, Drugs affecting the nervous system Antiallergic drugs system drugs central nervous system Drugs affecting the sensory nerve endings Cardiac CNS (AFFECTING THE Antihypertensive drugs Sulfonamides (, AFFERENT INNERVATION) drugs Antituberculous drugs analgesics-antipyretics, Antiarrhythmic drugs Antihelminthic drugs NSAIDs) Local anaesthetics Antihyperlipidemic drugs drugs and Coating drugs Spasmolytics Antiviral drugs drugs Adsorbents Drugs affecting the excretory system Antimalarial drugs Tranquilizers Astringents Antisyphilitic drugs Neuroleptics Expectorants Drugs affecting the hemopoietic system Antiseptics Irritant drugs Drugs affecting Disinfectants Antiparkinsonian drugs Drugs affecting peripheral Drugs affecting erythro- and leukopoiesis General anaesthetics processes Drugs affecting the digestive system CNS (AFFECTING THE drugs Psychomotor stimulants EFFERENT PART OF THE Bitter stuffs. Drugs for replacement therapy NERVOUS SYSTEM) Antiacid drugs Direct-acting-cholinomimetics Antiulcer drugs (Cognitive Anticholinesterase drugs Hepatoprotectors enhancers) M- cholinoblockers drugs. Drugs against Adaptogens Ganglionic blockers Drugs affecting Drugs affecting the Muscle relaxants Hormonal drugs of hypophysis, thyroid, cerebral blood circulation Adrenomimetics parathyroid, gonads, adrenal gland cortex, Adrenoblockers anabolic Insulins and oral hypoglycemic drugs , macro- and microelements . Antienzymes Drugs for transfusion therapy

NARCOTIC (OPIOID) ANALGESICS

CLASSIFICATION NATURAL AND SEMI-SYNTHETIC SYNTHETIC AGENTS AGENTS 1. 5. Trimeperidine (Promedol) 10. Dimenoxadol h/chl. (Estocin) 2. 6. 11. (Fortral) 3. Aethylmorphine h/chl. (Dionine) 7. Piritramide (Dipidolor) 12. (Moradol) Drugs and their synonyms 4. Omnopon 8. Tilidine (Valoron) 13. (Norphine) 9. 14.

Binding to opioid receptors in the CNS → inhibition of the algogens release on the whole way of pain impulses passing. Inhibition of the intercalary neurons of the spinal cord, reticular formation, thalamic pain centers, summation ability of the CNS.

Inhibition of the pain, cough, emetic and respiratory centers. Pharmacological effects Stimulation of vagus nerve and oculomotor nerve () centers.

Indications and Strong and very strong pains (1,3-14), neuroleptanalgesia (6), and post-operation period (1,4-14), labour analgesia (5,7,9,10), interchangeability colics (5-6,8-10,12), eye diseases (3), strong persistent cough (2,3,10).

Narcotic analgesics are incompatible with antiparkinsonian agents, MAO inhibitors, peripheral acting muscle relaxants, -adrenoblockers, , ACTH. Morphine is incompatible with aminazine in the same syringe. Promedol is incompatible with antihistaminic agents, tubocurarin chloride, trasicor. Pentazocine must not be injected with in the same syringe. Doctor and pharmacist, Codeine phosphate shouldn’t be taken together with . remember! Tramadol for injections is incompatible with solutions of , , nitroglycerin, . Narcotic analgesics aren’t prescribed for children up to 2 years and butorphanol - up to 18 years old. All drugs containing natural , inhibit the and secretion of GIT. Codeine as a part of the complex drugs causes and very rarely. Specific antagonist of the narcotic analgesics is . Before meals: 11.

ANALGESICS-ANTIPYRETICS

CLASSIFICATION DERIVATIVES PARAAMINOPHENOL COMBINED AGENTS DERIVATIVES

1. Methamizole (Analgin) 2. (Panadol) 3.Sedalgin 7. Citropac 4. Tempalgin 8. Cyclopar 5. Baralgin 9. Ascopar Drugs and their synonyms 6. Citramon 10. Paravit

Decrease of the pain impulses transmission through afferent nerves and inhibition of subcortical pain centers. Thermoregulation center Mechanism of action suppression.

Analgesic (1-10), antipyretic (1-3,6-10), anti-inflammatory (6-7,9), sedative (3,4), spasmolytic (5,8). Pharmacological effects Side effects: allergy, suppression of hemopoiesis (1-10), nephritis (2,3,4); , vomiting, methemoglobin formation, stomach ulceration (1,3- 5), decrease of blood coagulation (1,3,7).

Indications and Pains, not dangerous for life (headache, toothache, articular pain, etc.) (1-10), fever (2,6-7,9,10), neuralgia (1-4); colics, spasms of coronary and interchangeability cerebral vessels (5-8).

Doctor and pharmacist, Analgesics-antipyretics are incompatible with sulfonamides, antidepressants, glucocorticoids, . Analgesics, especially pyrazolone derivatives, are incompatible with salicylates, dichlothiazide. remember! The long-term administration of anticonvulsants may decrease the paracetamol activity.

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)

PYRAZOLONE AND COMBINED AGENTS ARYLCARBONIC AND CLASSIFICATION INDOLEACETIC AND OTHER DERIVATIVES ACID DERIVATIVES FENAMATES ACID DERIVATIVES NSAIDs* 1. Acetylsalicylic acid 3. (Ketonal) 6. 10.Phenylbutazone 13.Reopyrin () 4.Sodium (Movalise) (Butadion) 14.Novigan 2.Lysin acetylsalicylate (Voltaren, Orthofen) 7. 11. 15.Arthrotek (Aspisol) 5.Thiaprofenic acid 8. 12.Indomethacin 16.Fortalgin C (Surgam) (Donalgin) (Methindole) 17.* (Elderin) Drugs and their synonyms 9. 18. * 19. Diclocaine 20.Ascofen 21.Inflagesic plus 22.Valcofen

Suppression of the activity (COX), disturbance of the and synthesis, suppression of the Mechanism of action inflammatory mediators, hyaluronidase, lysosomal hydrolases activity. Decrease of the energy supply in the inflammatory focus. Inhibition of the subcortical pain centers.

Anti-inflammatory, antipyretic, , antiaggregant (1-22); sedative, anticonvulsive (22). Pharmacological effects Side effects: gastric ulceration, allergic reactions, bleedings, leukopenia, bronchospasm (seldom).

Diseases of the connective tissue (1-13,15,17,19); , arthralgia, bursitis (1-13,15-18,20-21); headache (1,2,9,14,16,20-22), hyperthermia Indications and (1,2,9,16,20-22); acute respiratory viral diseases (1,9,16,20-22), tendency of convulsive states appearance at high temperature in children (22), interchangeability pains in the traumatic injuries (1-5,7-10,12-18,21), arthritis (3-13,15,17,19,21), gout (10-13), glomerulonephritis (12), thrombophlebitis (1,2,10- 12), thromboprophylaxis, hypercoagulant syndrome (1,2); renal, hepatic and intestinal colics (14), postoperative pain syndrome (5,17,18,21).

Salicylates mustn’t be combined with other NSAIDs (the ulcerogenic effect increases) and anticoagulants (the risk of bleeding increases). Doctor and pharmacist, Butadion is incompatible with glucocorticoids. Indomethacin decreases the effects of -adrenoblockers and saluretics. remember! Meloxicam is incompatible with cyclosporin, methotrexate, diuretics. After meals: 1,3-5,8-10,15,17.

HYPNOTIC AND SEDATIVE DRUGS

HYPNOTIC DRUGS CLASSIFICATION CYCLOPYRROLONE

BENZODIAZEPINE DERIVATIVES* AND AGENTS SEDATIVE DRUGS DERIVATIVES DERIVATIVES FROM OTHER CHEMICAL GROUPS 1. Persen 10. (Radedorm) 15. (Luminal) 18. * (Imovan) 2. Sanason 11. (Lendormin) 16. (Fanodorm) 19. Metacvalone 3. Belloid 12. (Dormikum) 17. Cyclobarbital+Diazepam 20. (Ivadal) Drugs and their 4. Sodium 13. (Halcion) (Reladorm) 21. (Donormyl) 5. extract 14. Flunitrazepam (Rohypnol) synonyms 6. Corvalol (Valocordin) 7. Motherwort herb 8. Novo-passit 9. Cava-Cava extract (Antares)

Increase and concentration of the inhibitory processes in brain cortex; inhibition of the excitation processes in CNS (1-9). Mechanism of action Inhibition of brain polysynaptic structures. Decrease of activating influence from reticular formation to brain cortex. Increase of activity of the natural inhibitory mediator GABA (10-21).

Sedative (1-9), spasmolytic (1-3,5). Hypnotic, sedative (in low doses), potentiative, (10-21); (10-14), (10- Pharmacological effects 12,18).

Indications and Neuroses (1-10), neurogenic diseases (peptic ulcer, ischemic heart disease, hypertension) (1,3-8). : falling asleep disorders (9-13,15-21), duration disorders (10,11,13-15,18). Rapid relief of convulsion syndromes (10,15). Premedication (10,12,14). Itching dermatosis, , interchangeability climacteric syndrome (8).

Sedative drugs are incompatible with MAO inhibitors, -adrenomimetics, adrenocorticoids, -adrenomimetics, antiarrhythmic drugs (- like ones). Hypnotic drugs are incompatible with antidepressants, muscle relaxants, . Doctor and pharmacist, Barbiturates and can cause tolerance, addiction, euphoria, withdrawal syndrome. remember! Barbiturates (especially phenobarbital) are inductors of the microsomal enzymes. Phenobarbital is incompatible with , streptocide, h/chl, gentamycin, mesatone. Barbiturates are incompatible with cardiac glycosides. Before meals: 4,6,7. After meals: 8. TRANQUILIZERS ()

DIPHENYLMETHANE AND AGENTS FROM DIFFERENT CLASSIFICATION DERIVATIVES PROPANDIOL* DERIVATIVES CHEMICAL GROUPS

1. Diazepam (Seduxen) 11. Benactizine (Amizyl) 13. Benzoclidine h/chl. (Oxylidin) 2. (Chlozepide) 12. * (Meprotan) 14. Trimethozine (Trioxazine) 3. (Alzolam) 15. 4. (Nozepam) 16. (Atarax) 5. (Lexotan) Drugs and their synonyms 6. Mezapam (Rudotel) 7. Hydazepam 8. Dipotassium (Tranxen) 9. (Merlit) 10.

Binding to benzodiazepine receptors → increase of GABA activity (1-10); inhibition of the excitability of brain subcortical regions (thalamus, Mechanism of action hypothalamus, limbic system) and their connections with the brain cortex (1-16).

Psychosedative (anxiolytic, tranquilizing), potentiative (1-16), muscle relaxant (all drugs, except 6,7,13,15), moderate hypnotic (except 6), Pharmacological effects anticonvulsant (except 13).

Indications and Neuroses, minor psychoses (transitional states) (1-16); neurogenic diseases (hypertension, peptic ulcer, neurodermites) (1-13,16); interchangeability anaesthesiology (1,2,10-12), sleeping disorders (1-13,15), spastic states (1,2,11,12), depressions (8), withdrawal syndrome (1,2,7,10,16).

Tranquilizers mustn’t be combined with MAO inhibitors, derivatives, , CNS depressants. Tranquilizers are contraindicated to drivers and persons performing the work, that requires a quick psychic and physical reaction. Tranquilizers can cause addiction and tolerance. Doctor and pharmacist, “Daytime” tranquilizers are mezapam, rudotel, hydazepam, mebicar, benzoclidine h/chl, trimethozine. remember! Diazepam solution shouldn’t be combined with any other in the same syringe. Diazepam is incompatible with adrenaline h/chl, isadrin, , mesatone. The dose of tranquilizers should be decreased gradually avoiding the withdrawal syndrome. After meals: 11,12,14.

NEUROLEPTICS ( AGENTS)

PHENOTHIAZINE AGENTS FROM OTHER CLASSIFICATION BUTYROPHENONE DERIVATIVES DERIVATIVES CHEMICAL GROUPS

1. (Aminazine) 8. 11. (Orap) 2. (Tizercin) 9. 12. (Semap) 3. h/chl. (Aethaperazine) 10. Trifluperidol 13. 4. (Triphthazine) 14. Sulpyride (Eglonyl) Drugs and their synonyms 5. (Melleril) 15. (Leponex) 6. (Moditen) 16. (Topral) 7. Thioproperazine (Majeptil)

Mechanism of action Inhibition of the reticular formation → decrease of its influence on the brain cortex. Block of the function of mediators ( (especially block of D2-receptors), norepinephrine, ) in different parts of CNS.

Antipsychotic, potentiative, hypothermic, , adrenolytic, cholinolytic, cataleptogenic. Pharmacological effects Side effects: extrapyramidal disorders (catatonia, catalepsy, tremor) (1-14,16), sedative effect (apathy, lethargy, drowsiness)(1-7).

Indications and Psychoses (1-16); anaesthesia, premedication (1-3,8,9), intractable vomiting (1,3,4,7,9,10), hypertensive crisis (1,2,8), dermatoses (1-3,13), transitional psychoses (11), hyperthermia, resistant to the antipyretics (1), neuroleptanalgesia (8,9), shock (8). interchangeability

Neuroleptics are incompatible with anticholinesterase agents, MAO inhibitors, cholinomimetics, adrenomimetics, antihypertensive agents and CNS depressants. are incompatible with tricyclic antidepressants. Doctor and pharmacist, Aminazine is incompatible with adrenaline h/chl, amytriptilin, , morphine, B12, cardiac glycosides. remember! Haloperidol is incompatible with adrenaline h/chl, sombrevin; it decreases the effects of indirect-acting anticoagulants. Aminazine has anti-inflammatory and local irritating effects. Before meals: 11,13. After meals: 1,3,4,7,9,10,15.

ANTICONVULSANTS

CLASSIFICATION ANTIEPILEPTIC AGENTS AGENTS, STOPPING CONVULSIONS IN OTHER STATES 1. Phenobarbital 7. (Tegretol) 13. Diazepam (Seduxen) 2. (Benzonal) 8. (Antelepsin) 14. 3. Benzoilbarbamyl (Benzobamyl) 9. Ethosuccimide (Suxilep) 15. hydrate 4. (Hexamidine) 10. Pufemide 16. sulfate Drugs and their synonyms 5. (Diphenin) 11. Valproic acid (Convulex) 6. (Chloracon) 12. (Lamictal)

Inhibition of the activity of brain cortex and subcortex motor zones. Increase of the content of inhibitory transmitter GABA in the CNS. Mechanism of action Decrease of the aminoacids (glutamate, aspartate) effect on CNS.

Pharmacological effects Anticonvulsant (1-16), sedative (1,3,14,16), hypnotic (1-4,13,15), anxiolytic (9,11,13,14).

Indications and Major (1-8,11-13); minor epilepsy (8-11,14); neuralgia of trigeminal nerve (7,9); convulsions because of tetanus, eclampsia; interchangeability intoxications by convulsive (13-16).

Anticonvulsants are incompatible with anticholinesterase agents, β-adrenomimetics, antidepressants, cholinomimetics, isoniazide and its derivatives, coumarins, acetylsalicylic acid, teturam. Carbamazepine and valproic acid (taking together) can cause coma. Carbamazepine is incompatible with tetracyclins. Doctor and pharmacist, Sodium is absolutely incompatible with alcohol. Withdrawal syndrome is typical for anticonvulsants. remember! Diphenin is incompatible with gentamycin, , proserine, sulfonamides, . Diphenin has antiarrhythmic effect and it is used for treatment of tachyarrhythmia. is incompatible with atropine sulfate, dibazol, prednisolone, mesatone. Before meals: 10. After meals: 2-7,9,11.

ANTIPARKINSONIAN DRUGS

CLASSIFICATION AGENTS DOPAMINERGIC AGENTS

5. Levodopa (Levopa) 1. (Cyclodol, Parkopan) 6. Nacom (Levodopa+Carbidopa) 2. Triperiden (Norakin) 7. Madopar Drugs and their synonyms 3. Diphenyltropine h/chl. (Tropacine) 8. (Midantan) 4. Diethazine h/chl. (Dinezine) 9. Gludantane 10. (Parlodel)

Central (preferably) and peripheral anticholinergic Increase of dopamine content in CNS. Stimulation of dopaminergic receptors in Mechanism of action (cholinolytic) effect. CNS; increase of their sensibility to dopamine.

Antiparkinsonian (elimination of parkinsonism symptoms) (1-10): muscular rigidity and stiffness (1,2,5-10), tremor (5,9), hypersalivation Pharmacological effects (1,2,5), hyperhidrosis, skin obsceness (3,4); antiviral (8,9).

Indications and Parkinson's disease (1-10); spastic pareses and paralyses (1,3); extrapyramidal disorders, caused by neuroleptics (1,2,9,10); hereditary interchangeability extrapyramidal disorders (5); acromegaly, Cushing's syndrome, suppression of lactation (10); prophylaxis and treatment of viral (8,9).

Antiparkinsonian drugs are incompatible with cholinomimetics, anticholinesterase agents, neuroleptics, tranquilizers, narcotic analgesics. Bromocriptine is incompatible with ergot alkaloids, oral contraceptives, MAO inhibitors, CNS depressants. Levodopa, madopar, nacom are incompatible with MAO inhibitors and vitamin B6. Doctor and pharmacist, Levodopa is incompatible with drotaverin. Trihexyphenidyl and triperiden are contraindicated to patients with and should be carefully prescribed to patients with hypertension remember! and atherosclerosis. Dinezine must be alternated with other antiparkinsonian drugs. Gludantane is used in viral eye diseases treatment. After meals: 3-9,10.

ANTIDEPRESSANTS

MAO INHIBITORS SELECTIVE CLASSIFICATION TRICYCLIC, TETRACYCLIC* (REVERSIBLE, INHIBITORS OF PLANT ORIGIN, AGENTS IRREVERSIBLE*) COMBINED* AND REUPTAKE OTHER** AGENTS 1 Mianserine* (Miansan) 5. Nialamide* (Nuredal) 7. (Prozak) 9. Hyperycin (Deprim) 2. (Amizol) 6. Pyrazidol (Pyrlindol) 8. (Zoloft) 10. Amixide* Drugs and their synonyms 3. (Sinequan) (Amitriptyline+Chlordiazepoxide) 4. (Melipramine) 11. Thianeptine** (Coaxyl)

Decrease of noradrenaline, dopamine, Block of the MAO Inhibition of serotonin Inhibition of MAO activity (9). serotonin reuptake increasing their (5,6). reuptake increasing their Influence on the limbic system Mechanism of action accumulation in the synaptic cleft (1-4,10). accumulation in the synaptic (10). Increase of serotonin cleft (7,8). reuptake by the neurons of the brain cortex and hippocamp (11).

Pharmacological effects , thymoleptic, potentiative (1-11); cholinolytic (2,4,7), sedative (1-3,10), stimulant (4-7,9), anxiolytic (1-4,10,11), (6).

Indications and Depressions (1-8,10-11), psychoasthenic states (9), enuresis in children (4), psychopathies, neuroses (3,4,7), withdrawal syndrome (6,11), interchangeability Alzheimer’s disease (6), neuralgia of the trigeminal nerve (5), nervous bulimia (7).

Antidepressants are incompatible with anticholinesterase agents, psychomotor stimulants, cholinomimetics, indirect-acting anticoagulants, sympatholytics, butadion, salicylates, heparin. MAO inhibitors are incompatible with , phenothiazines, M- and N-cholinoblockers, oral hypoglycemic drugs, narcotic analgesics, Doctor and pharmacist, neuroleptics, tricyclic antidepressants, reserpine, lidocaine. Tricyclic antidepressants are incompatible with α- and β- adrenoblockers, antihistaminic drugs, MAO inhibitors, anticonvulsants, phenothiazines, remember! salbutamol. Nialamide can cause “cheese” syndrome, that’s why patients should avoid eating food containing tyramine during the treatment. Amitriptyline is incompatible with aminazine, reserpine, oral contraceptives. Before meals: 11. After meals: 2,4,5.

ANALEPTICS AND PSYCHOMOTOR STIMULANTS

CLASSIFICATION ANALEPTICS PSYCHOMOTOR STIMULANTS 1. Bemegrid 7. Caffeine sodium benzoate 2. Niketamide (Cordiamine) 8. Amphethamine sulfate (Phenamine) 3. Sulfocamphocaine 9. Mesocarb (Sydnocarb) Drugs and their synonyms 4. 10. Pheprosidine h/chl. (Sydnophen) 5. Ethymizole 6. (Cytitone)

Enhance and regulation of the excitation processes in the brain Mechanism of action Stimulation of respiratory and vasomotor centers. cortex; promotion of noradrenaline and dopamine release in CNS.

“Awaking” effect (increase of BP, stimulation of respiration); antagonism Stimulation of the mental and physical activity (7-10); increase Pharmacological effects with , narcotic analgesics (1-6). Increase of myocardial contractility of BP (7,8); decrease of the fatigue and drowsiness (7-10); (2,3). Increase of smooth and skeletal muscles (convulsions) tone; increase of thymoleptic effect (9,10); cardiostimulative effect, decrease of the acuity of vision, olfaction, hearing, taction (4). Increase of ACTH level; the aggregation, increase of gastric juice secretion (7); spasmolytic, anti-inflammatory, antiallergic effects (5). anorexigenic effect (8).

Acute intoxications by hypnotics and narcotic analgesics (1,3,5,7). Acute and Decrease of mental and physical activity (7-10), migraine (7), Indications and chronic blood circulation disorders (2,6). Shock, collapse, asphyxia (2,3,5,6). enuresis in children (9); depression , narcolepsy (8,10); asthenic interchangeability Acute and chronic (3,4,7). Pareses, paralyses, atonia of stomach states (9,10). (4).

Analeptics are incompatible with adrenoblockers, antiarrhythmic drugs and MAO inhibitors. Cordiamine is incompatible with . Psychomotor stimulants are incompatible with sympatholytics, oral hypoglycemic drugs, antidepressants, M-cholinoblockers, antiarrhythmic Doctor and pharmacist, drugs. Caffeine is incompatible with aminazine, butamide, vitamin B6, vitamin PP, digitoxin, streptocide, benzohexonium. remember! Phenamine is distributed with the same limitations as narcotic analgesics are. Analeptics and psychomotor stimulants are taken in high doses in case of acute CNS suppression. Caffeine and strychnine are not prescribed for children up to 2 years old. Caffeine is an ingredient of Ascofen, Citramon, Caffethamine. After meals: 5,9.

NOOTROPICS (COGNITIVE ENHANCERS) AND ADAPTOGENS

CLASSIFICATION NOOTROPICS ADAPTOGENS

1. Pyracetam (Nootropil) 6. root tincture 2. Gamma-aminobutyric acid (Aminalon) 7. Pantocrin 3. Sodium oxybutyrate 8. Saparal Drugs and their synonyms 4. Pyriditol (Encephabol) 9. Aralia tincture 5. Phenybute 10. Eleutherococcus extract 11. Rhodiola liquid extract 12. Citrullin (Stimol)

Improvement of ATP metabolism, increase of adenylate cyclase Stimulation of protective mechanisms in organism (nonspecific Mechanism of action activity (1). Stimulation of metabolic processes, neurotransmission resistance) (6-11). Participation in cycle, in Krebs’ cycle; in CNS (4). Affinity to GABA-receptors (2,3,5). restoration of gluconeogenesis (12).

Improvement of blood supply and energy processes in the brain, increase of CNS resistance to hypoxia and aggressive influences (1- Stimulation of cardio-vascular system, increase of mental and physical 5). Elimination of memory disorders, activation of intellectual and activity and body resistance to unfavourable conditions (6-11). Pharmacological effects cognitive functions, stimulation of studying processes (1,2,4); Elimination of ammonium , decrease of lactate level in blood, that is antishock, central muscle relaxant, sedative effects (3); tranquilizing correction of metabolic processes (12). effect (5).

Craniocerebral injuries, stroke, chronic cerebro-vascular disorders, atherosclerosis, children mental deficiency, memory disorders, Asthenia (6-12), (6-9), overload, neurasthenia (6-8,11,12); Indications and psychoses, depressive states, senile (1,2,4). Abstinence; diseases, recovery period after chronic diseases and traumas intoxications with alcohol, narcotic analgesics, barbiturates (1). (6,7,11,12); increased drowsiness (6,10), vegetovascular dystonia (11), interchangeability , hypoxia, open-angle glaucoma (3). Migraine sexual asthenia (6,12), myocardial weakness (7). (4). Ménière's disease, motion sickness prophylaxis, neurotic states, stammering, children tics (5).

BP fluctuations are possible during the first days of aminalon intake. Doctor and pharmacist, Ginseng drugs have well-defined seasonality of action: they are most effective in autumn and winter. Before meals: 1,2,6,7,9-11. remember! During meals: 12. After meals: 4,5,8.

DRUGS AFFECTING AFFERENT INNERVATION

ADSORBING CLASSIFICATION ASTRINGENT, COATING, ANTIACID AGENTS VOLATILE OILS BITTERS LOCAL AGENTS ANESTHE- Plant origin: 8. Tanalbin 14. Vicair 21. Activated 24. 29. Wormwood TICS (see P. 1. Oak bark 9. Romasulan 15. Vicalin charcoal 25. Validol herb 22) 2. St. John’s wort Metal salts: 16. Bismuth (Carbolen) 26. Pepper mint 30. Dandelion herb 10. subcitrate (De-nol) 22. Carbolong 27. seed root EXPECTO- 3. Sage leaf hydroxide 17. Xeroform 23. Enterosgel 28. Eucalyptus leaf 31. Centaury Drugs and their synonyms RANTS 4. 11. Alumag 18. Magnesium herb (see P. 21) flowers 12. oxide 32. Sweet flag 5. Bur-marigold herb 13. Aluminium rhizome 19. Anacid 6. Alder collective phosphate 20. Lead acetate (see P. 51) (Phosphalugel) 7. Tannin Irritation of Coating of the afferent nerve endings (10-13,19,23); neutralization of free HCl of the gastric juice Irritation of afferent gustatory (18,19); precipitation, forming the albuminates and decreasing the irritation of the afferent nerve endings, reflex receptors, reflex Mechanism of action nerve endings of the GIT (1-9,14-17); adsorbtion of the chemical substances on dilation of arterioles increase of their surface (12,13,19,21-23). and capillaries. gastric juice secretion. Local irritant, distracting (24,27), anti- Increase of appetite, Coating (10-13,19,23), adsorbing (12,13,19,21-23), astringent (1-9,14,17,20), mild anti- inflammatory (28), analgesic (24,26), improvement of Pharmacological effects inflammatory (3-5,9,14,15), antiacid (10-16,18-19), sudorific (4), cytoprotective, antibacterial (16). spasmolytic (24,25), digestion (29- sedative (25,26), 32). antiseptic (24,28). Neuralgia (24,26), Externally: burns, bedsores, ulcers, intertrigos, inflammatory dermatoses (1-7,17,20); inflammatory myalgia, arthralgia (24), Decrease of Indications and diseases of the fauces, gingivitis, stomatitis (1-4,7,9). migraine (24), appetite, respiratory organs interchangeability Internally: colites, enterites, gastrites, peptic ulcer (2,4,7-16,18-19); food intoxications (13,21-23), diseases (24,27,28), hypoacid hyperphosphatemia (19), intoxications (7,21-22). angina pectoris (25), for gastritis (29-32). sedation (25). Antiacids should not be combined with NSAIDs, antiulcer drugs, diuretics, antibiotics, isoniazide, fluoroquinolones and iron salts. Doctor and pharmacist, Bitters should be taken in 15-20 minutes before meals. remember! Before meals: 11,16,29-32. After meals: 12-15,18,19.

EXPECTORANT, MUCOLYTIC, ANTITUSSIVE DRUGS

DRUGS STIMULATING ANTITUSSIVE DRUGS: MUCOLYTICS CENTRAL ACTING CLASSIFICATION EXPECTORATION (MONOCOMPONENT, (NARCOTIC AND PERIPHERAL (REFLEX AND RESORPTIVE * COMBINED* DRUGS) NON-NARCOTIC*) ACTING** ONES ACTING ONES) ONES 1. Thermopsis herb 7. Althaea root* 13. (Mucobron, Lasolvan) 21. Codeine phosphate 2. Milkwort root 8. Mucaltin* 14. Acetylcystein (ACC) 22. Dimemorphan (Dastosine) 3. Glycyrrhiza root 9. leaf 15. Bromhexin (Solvin) 23. Dimenoxadol h/chl. (Estocin) 4. Inula root* 10. Pertussin* 16. Carbocystein (Bronchocode, Mucosol) 24. (Glauvent)* Drugs and their synonyms 5. Ledum herb* 11. Therpin hydrate* 17. (Mistabrone) 25. (Sinecode)* 6. Menthoclar* 12. Sodium 18. Solutan* 26. (Tusuprex)* benzoate* 19. Bronchicum* 27. Prenoxdiasin (Libexin)** 20. Eucabal* 28. Pronilid (Falimint)** 29. Pentoxyverin (Sedotussin)**

Stimulation of formation (13,15); Suppression of cough center (21-26). activation of hydrolizing enzymes, decrease Reflex (1-12) and resorptive (4-8, 10-12) Block of afferent receptors of trachea, bronchioles, Mechanism of action of sputum viscosity, improvement of action on bronchioles and bronchial glands. lungs (27-29). sputum transport (13-20).

Antitussive (21-29), mild local (27-29), Mucolytic, expectorant (13-20), mild Expectorant (1-12); mucolytic (4-8, 10-12), anti-inflammatory (25,27), expectorant (25), antitussive (13); broncholytic, antibacterial, Pharmacological effects coating (7), mild anti-inflammatory (2,4,6). broncholytic (25,27,29), analgesic (21,23), mild anti-inflammatory (19,20). sedative (22), adrenolytic (24), disinfectant (28).

Indications and As a part of the complex therapy of the respiratory tract inflammatory diseases (acute and chronic tracheites, bronchites and ) (1-29). interchangeability Investigation of antitoxic function of liver (11).

Acetylcystein solution should not be combined with solutions of antibiotics in the same syringe. , cephalosporins and tetracyclins should be taken not earlier than in 2 hours after administration of acetylcystein. Doctor and pharmacist, Codeine phosphate should not be taken together with methotrexate. The following drugs (1-5, 7-11) are contraindicated in gastric diseases. remember! Ambroxol, bromhexin are incompatible with alkaline solutions; with drugs containing codeine. Solutan contains ephedrin and can cause tachyarrhythmia. Before meals: 4. After meals: 7,18, 24. LOCAL

PARA-AMINOBENZOIC BENZOFUROCARBOXYLIC SUBSTITUTED CLASSIFICATION COMBINED AGENTS ACID (PABA) ESTERS ACID ESTERS ACETANYLIDE

1. (Novocaine) 4. Benzofurocaine 5. (Ultracaine) 10. Lidocaton 2. (Anesthesin) 6. Lidocaine (Xylocaine) (Lidocaine+Epinephrine) 3. h/chl. (Dicaine) 7. (Marcaine) 11. Ultracaine D-S 8. h/chl. (Articaine+Epinephrine) Drugs and their synonyms 9. Bumecaine h/chl. 12. Pavesthesin (Pyromecaine) (Anesthesin+ h/chl)

Decrease of the membrane permeability for Na+ and K+ ions, prevention of the action potential formation; inhibition of the Mechanism of action release; change of the surface tension of membrane phospholipids.

Local anesthetic (1-12), antiarrhythmic (1,5,6,9,10,11), hypotensive (1,5,6,10-12), central analgesic (4), spasmolytic (12). Pharmacological effects

Indications and Infiltration (1,4-8,10,11), terminal (2,3,6,9,10), conduction (1,5-8,10,11), spinal (1,5,7,8,11), lumbal block (5,11), paracervical, caudal, intercostal, epidural (7), peridural (8) ; tachyarrhythmia (6,9,10), gastralgia, spasms of intestine and stomach smooth muscles (12); interchangeability hepatic and renal colics, peritonitis, pleuritis, (4).

Local anesthetics are incompatible with M-cholinomimetics, cardiac glycosides, vasodilators (papaverine, , dibazol), - adrenoblockers, quinidine, anticholinesterase agents. Novocaine is incompatible with sulfonamides. Doctor and pharmacist, It is forbidden to mix benzofurocaine solution with and other solutions with alkaline reaction. remember! Lidocaine can cause hypotension, bradycardia. Convulsions and psychomotor excitement are possible in case of lidocaine overdosage. PABA esters should be taken carefully by patients with allergy to sulfonamides. When using simultaneously bupivacaine and oxytocin or , a sharp rise of BP and stroke development are possible. While using bupivacaine one should avoid the prolonged contact with the metal parts of the syringe.

DRUGS FOR TREATMENT BRONCHIAL

 + -ADRENOMIMETICS; PHOSPHODI- THROMBOXANE- 1 2 M-CHOLINO- GANGLIONIC CLASSIFICATION  -ADRENOMIMETICS *; ESTERASE SYNTHETASE 2 BLOCKERS BLOCKERS +-ADRENOMIMETICS ** INHIBITORS INHIBITORS 1. Orciprenaline 3. Clenbuterol* 6. Epinephrine** 7. Theophylline 9. Ipratropium 11. 12. Drugs and their sulfate 4. Salmeterol* (Adrenaline (Retaphyll) bromide benzosulfonate (Domenan) 2. Isoprenaline 5. Fenoterol* hydrotartrate) 8. (Atrovent) (Benzohexonium) synonyms (Euphylline) 10. Oxytropium bromide (Ventilat) Block of M-cho- Selective inhibition Block of linoceptors → of thromboxane A Stimulation of decrease of Block of N-cho- synthesis → decrease Stimulation of  - Stimulation of +- → increase of  + -adreno- 2 parasympathetic linoceptors of the of thromboxane Mechanism of action 1 2 adrenoceptors. adrenoceptors. cAMP level → ceptors. nervous system autonomic ganglia. influence on decrease of smooth influence on bronchial smooth muscles tone. bronchi. muscles. Pharmacological Antiasthmatic, bronchodilative (1-12); (7), tocolytic (1-5), vasodilative (7,8,11). effects Indications and Bronchial asthma (1-12), asthmatic status (6,8), chronic with asthmatic component (1-5,9), anaphylactic shock (6), spasms of peripheral interchangeability vessels (8,11), cerebral circulation disorders (8), preterm labour (4,5). +-adrenomimetics are incompatible with oral hypoglycemic drugs, indirect-acting anticoagulants, sedatives, cardiac glycosides, sympatholytics, sulfonamides, diuretics, insulins, muscle relaxants, other broncholytics from adrenomimetics, MAO inhibitors, -adrenoblockers, -containing drugs, vitamin D, corticoids. M-cholinoblockers are incompatible with psychomotor stimulants, MAO inhibitors, emetic agents. Adrenaline is incompatible with aminazine, , phenobarbital, aminophylline, seduxen, , digitoxin, dicumarin, dibazol, haloperidol. While using theophylline and aminophylline with fluoroquinolones their doses are decreased up to ¼ from recommended dose. Doctor and Aminophylline mustn’t be used with glucose solution and xantine derivatives; it is incompatible with vitamins C, B6, PP, prednisolone, dibazol. Isadrin is incompatible with butamide, sodium , digitoxin, dicumarin, streptocide, seduxen, proserin, diphenine. pharmacist, Salmeterol is prescribed only to grown-ups. remember! Theophylline, aminophylline, theophedrine N should be used in the morning or in day-time in order to prevent sleeping disorders.

One should use membrane stabilizers, 2-adrenomimetics or their combination if there are bronchial attacks less then 1 time a week with short-time exacerbations.

2-adrenomimetics, inhalation glucocorticoids, membrane stabilizers and combined drugs are used in case of long-lasting bronchial asthma (attacks more often then 1 time a week, night attacks are 2 times a week). In case of medium-severe bronchial asthma (everyday attacks, night symptoms more often then 1 time a week) inhalation or oral glucocorticoids (in

doses 800-1000 mcg/day), prolonged 2-adrenomimetics, phosphodiesterase inhibitors, inhalation M-cholinoblockers are used. It is rational to use membrane stabilizers, inhalation glucocorticoids, drugs for bronchial asthma prophylaxis. DRUGS FOR TREATMENT BRONCHIAL ASTHMA (CONTINUATION).

LEUKOTRIENE ANTIHISTAMINE AND MAST CELL COMBINED CLASSIFICATION D -RECEPTORS ANTITRANSMITTER* GLUCOCORTICOIDS MEMBRANES 4 DRUGS ANTAGONISTS DRUGS STABILIZERS

13. Sodium montelucast 15. Loratadin (Claritin) 18. Budesonid (Pulmicort) 21. Sodium cromoglycate 24. Berodual (Singular) 16. Astemisol 19. Flunisolid (Inhacort) (Intal) 25. Ditec Drugs and their synonyms 14. Zafirlucast (Acolat) 17. Phenspirid h/chl.* 20. Beclomethasone (Beclomet) 22. Sodium nedocromyl 26. Intal plus (Erespal) (Tayled) 27. Theophedrine N 23. (Zaditen) Stimulation of Inhibition of formation and bronchial  - secretion of leukotrienes, 2 adrenoceptors (24- serotonin, prostaglandins. Stabilization of mast cell Competitive Block of H - 27), block of 1 Inhibition of cytokines release membranes → decrease of antagonism with C , D , receptors (15-17), decrease of bronchial M- Mechanism of action 4 4 from macrophages. Decrease of histamine release; block of E leukotrienes. cytokines production (17). cholinoceptors (24), 4 tissue receptors sensitivity to Ca2+-canals in mast cells. stabilization of mast and allergy cell membranes transmitters. (25,26).

Pharmacological effects Antiasthmatic, antiallergic (13-27); bronchodilative (24-27), anti-inflammatory (13-14), immunosuppressive (18-20).

Indications and Bronchial asthma (13-27), cold, physical over-exertion, aspirin asthma (13,14,22,23), -dependent bronchial asthma (18-20); prophylaxis of interchangeability atopic bronchial asthma attacks (15-17,21-26), pollinosis (15-17,21,23), asthmatic status (20).

Combined drugs are used for rapid relief of atopic asthma symptoms (ditec, intal plus, berodual). Doctor and pharmacist, Bromhexin and ambroxol shouldn’t be inhalated in one mixture with intal solution. Ketotifen in combination with oral hypoglycemic drugs causes thrombocytopenia and potentiates effects of CNS depressants. remember! Before meals: 13,17. After meals: 23.

CLASSIFICATION OF THE DRUGS AFFECTING THE EFFERENT PART OF THE NERVOUS SYSTEM

Cholinergic agents Anticholinergic agents Adrenergic agents Antiadrenergic agents ( , (cholinergic antagonists, (adrenergic agonists, (adrenergic antagonists, cholinomimetics) cholinoblockers) adrenomimetics) adrenoblockers)

Direct-acting Indirect-acting agents α-, α-, Sym- agents – cho- (anticholinesterase patho- linomimetics: agents) α- β- β- α- β- β- lytics M- N-

M- M-, N- α 1 α2 α α 1 2 N- α1A α1B

α1, α2

Reversible- Irreversible- Ganglionic Muscle β β +β β , β 1 1 2 acting ones acting ones blockers relaxants β1 β 2 1 2

While taking the cholinergic drugs, there is more parasympathetic innervation in the organism, while M-cholinoblockers or adrenergic agents – Doctor and pharmacist, there’s sympathetic. remember! The site of action for all drugs affecting peripheral neurotransmitter processes is postsynaptic membrane, except sympatholytics, ephedrine, (presynaptic membrane).

CHOLINERGIC AGONISTS

INDIRECT-ACTING CHOLINOMIMETICS DIRECT-ACTING CHOLINOMIMETICS CLASSIFICATION (ANTICHOLINESTERASE DRUGS) M-, N-CHOLINOMIMETICS M-CHOLINOMIMETICS N-CHOLINOMIMETICS REVERSIBLE- AND IRREVERSIBLE*- ACTING ONES 1.Acetylcholine 3. 5.Cytitone 7. (Eserin) 2. 4.Aceclidine 6. 8. Halantamine (Nivaline) 9. (Proserin) Drugs and their 10. Ambenonium h/chl. (Oxazyl) synonyms 11. Pyridostigmine bromide (Calimine) 12. Distigmine bromide (Ubretid) 13. Armine*

Mechanism of action Stimulation of cholinoceptors. Inhibition of acetylcholinesterase.

Pharmacological Decrease of intraocular pressure (2-4,7,9,13); stimulation of respiration (5-6); increase of tone of intestine, urinary bladder, , bronchi (1-4,7-12); effects improvement of neuromuscular conductivity (7-12); dilation of peripheral vessels (1,7-11).

Indications and Glaucoma (2-4,7,9,13), radiodiagnosis of GIT diseases (1,4,8); atonia of intestine and urinary bladder (1,2,4,7-9,12); pareses, paralyses, myasthenia (7- interchangeability 12); weak uterine contractions (4,9); intoxications by muscle relaxants, M-cholinoblockers (7-9); endarteritis (1); reflex respiratory stoppage (5,6).

Cholinomimetics are incompatible with antiparkinsonian drugs, anticonvulsants, antidepressants, antiarrhythmic drugs, neuroleptics, antihistaminic drugs, β-adrenoblockers, glucocorticoids and antibiotics-aminoglycosides. M–cholinomimetics are incompatible with antihistaminic drugs, local anesthetics. Anticholinesterase drugs are incompatible with local anesthetics, antiparkinsonian drugs, neuroleptics, anticonvulsants, tricyclic antidepressants, Doctor and antiarrhythmics, β-adrenoblockers. pharmacist, Acetylcholine is incompatible with mesatone, lidocaine. remember! Proserin is incompatible with trasicor, diphenine, isadrin. Acetylcholine isn’t injected intravenously. Absence of the effect of reversible-acting anticholinesterase drugs can be explained by their overdose. Before meals: 9,12. After meals: 10.

M-CHOLINOBLOCKERS

1. Atropine sulfate 7. (Gastrozepine) 2. hydrobromide 8. (Atrovent) 3. h/chl. 9. (Mydrium) Drugs and their synonyms 4. Platiphylline hydrotartrate 10. Butylscopolamine bromide (Buscopan) 5. Adiphenine (Spasmolytin) 11. Aprophen 6. Metacine iodide 12. Besalol (Belladonna extract + phenylsalicylate)

Mechanism of action Block of M-cholinoceptors.

Dilatation of pupil Inhibition of Central Spasmolytic (1-12), antiseptic (12) (mydriasis), increase of exocrine glands (1-5). anticholinergic effect Pharmacological effects effects. intraocular pressure (1-4,9,12). secretion (1-12). (1-5,11,12).

Bronchial asthma (1,3,4,6,8); Diagnosis of eye diseases (1- Peptic ulcer (1,4- intestinal, hepatic (1,3-6,10-12), Heart stoppage, Indications and 4,9), inflammatory eye 7,10-12); renal (1,3-6,10,11) colics; threat of bradycardia; intoxication by Motion sickness, interchangeability diseases (1,3), selection of premedication preterm labour (6); brain and heart cholinomimetics and parkinsonism (3). lenses (1,2,4,9). (1,3,6). vessels spasms (11); endarteritis anticholinesterase drugs (1). (5,11).

M-cholinoblockers are incompatible with psychomotor stimulants, MAO inhibitors, emetics, caffeine, digitalis drugs, clonidine. Atropine sulfate is incompatible with barbital (hypnotics), morphine, magnesium sulfate, acetylsalicylic acid, dibazol, acetylcholine. Doctor and pharmacist, M-cholinoblockers are contraindicated in glaucoma. The concentration of atropine sulfate solution for injections is 0,1%, as eye drops - 1%. remember! Adiphenine causes dizziness and of drunkenness that’s why it is contraindicated to drivers and people performing a rapid work. Before meals: 1,4,6,7,10. After meals: 5.

N – CHOLINOBLOCKERS

MUSCLE RELAXANTS (DEPOLARIZING* AND CLASSIFICATION GANGLIONIC BLOCKERS NONDEPOLARIZING AGENTS) 1. Hexamethonium benzosulfonate (Benzohexonium) 7. Suxamethonium iodide* (Dithilin) 2. Azamethonium bromide () 8. (Norcuron) 3. Dimecolin iodide (Dimecolin) 9. Diplacin Drugs and their synonyms 4. Trepirium iodide (Hygronium) 10. 5. Pempydine tosilate (Pyrilen) 11. Mellictin 6. Pachycarpine hydroiodide 12. (Arduan)

Block of N-cholinoceptors of the autonomic ganglia. Competitive antagonism with acetylcholine (8-12). Mechanism of action Pharmacological denervation of organs (1-6). Stable depolarization of postsynaptic membrane (7).

Peripheral vessels dilatation, decrease of BP; decrease of smooth Pharmacological effects muscles tone; decrease of exocrine glands secretion (1-6). Increase Total skeletal muscles relaxation (7-12). of uterine tone (6).

Indications and Hypertension, hypertensive crisis (1-6); edema of brain, lungs (2); Controlled respiration and relaxation during the general anesthesia, endarteritis (1-3,5,6); controlled hypotension (1,2,4); peptic ulcer alleviation of the fragments reposition, reduction of dislocations (7- interchangeability (1,3,5); bronchial asthma (1,2); colics (2,3); labor induction (6); 12); (11); intubation of trachea (7,9,11); eyeball dehydratation cholecystitis (3); eclampsia (2,4). (9); parkinsonism (11).

N-cholinoblockers are incompatible with MAO inhibitors, anticholinesterase drugs. N-cholinoblockers shouldn’t be mixed with barbiturates solutions in the same syringe. Muscle relaxants are incompatible with adrenomimetics, heparine, strophanthin, adrenal corticoids, narcotic analgesics. Benzohexonium is incompatible with mesatone, caffeine, dibazol. Doctor and pharmacist, Tubocurarine chloride is incompatible with promedol. All ganglionic blockers can cause orthostatic collapse. remember! Benzohexonium causes tolerance. Ganglionic blockers are contraindicated to patients with acute myocardial infarction, marked hypotension, shock, liver and kidney dysfunctions, thromboses, degenerative changes in CNS. All nondepolarizing muscle relaxants are histamine inductors, that’s why they can cause pseudoallergic reactions, especially, bronchospasm. Before meals: 1,3,6. ADRENERGIC AGONISTS

    -ADRENOMIMETICS,  -ADRENO-  -ADRENOMIMETICS *   -ADRENO- 1, 2, 1, 2 CLASSIFICATION  -ADRENOMIMETICS 2 1 1+ 2 DOPAMINE RECEPTORS 1 MIMETICS  -ADRENOMIMETICS MIMETICS 2 STIMULATOR** 1. Norepinephrine 6. Guanfacin 8. Dobutamine* (Dobutrex) 15. Isoprenaline 16. Epinephrine (Adrenaline) (Noradrenaline) (Estulik) 9. Orciprenaline sulfate (Asthmopent) (Isadrin) 17. Ephedrine h/chl. 2. Phenylephrine h/chl. 7. Clonidine 10. Fenoterol (Berotek) 18. Dopamine** Drugs and their (Mesatone) (Clofeline) 11. Salbutamol (Ventoline) synonyms 3. Xylometazoline 12. Terbutaline (Brycanyl) (Halazoline) 13. Clenbuterol (Spyropent) 4. Oxymetazoline (Nasol) 14. Salmeterol (Salmeter) 5. Tetrizoline (, Tisine) Stimulation of β -, Stimulation of  - Stimulation of β - Stimulation of β - 1 Stimulation of  -,  -,  -,  - Stimulation of  -adrenoceptors 2 1 2 β -adrenoceptors in 1 2 1 2 1 adrenoceptors in adrenoceptors in adrenoceptors in 2 adrenoceptors (16-18); stimulation of Mechanism of action in vessels. bronchi and vasomotor center. myocardium. bronchi and uterus. dopamine receptors (18). myocardium. Inhibition of the Cardiostimulative, hypertensive (16- vasoconstrictive Pharmacological Cardiostimulative Broncholytic, Cardiostimulative, 18); broncholytic (16,17), diuretic (18) Vasoconstriction, increase of BP. impulses from the effect. tocolytic effects. broncholytic effects. effects. Activation of glycogenolysis effects CNS (hypotensive and lipolysis (16,17). effect). Heart stoppage Threat of Cardiogenic shock, Heart stoppage, anaphylactic (8,9); cardiogenic preterm labour bradyarrhythmia, shock, bronchial asthma, Shock, collapse (1,2), rhinitis shock, (10-12); chronic Indications and Hypertension bronchial asthma, hypoglycemic coma, enuresis, (3-5), hypotension (2), bradyarrhythmia, asthmatic chronic asthmatic (6,7). prolonging of local anesthetics interchangeability conjunctivitis (5). intoxication by bronchitis and bronchitis, effect (16,17); open-angle cardiac glycosides bronchial asthma emphysema of lungs glaucoma (16). (9). (9-14). (15). α1 – adrenomimetics are incompatible with oral hypoglycemic agents, indirect-acting anticoagulants, sedatives, sympathomimetics, sulfonamides, cardiac glycosides. β-adrenomimetics are incompatible with antiarrhythmics, oral hypoglycemic agents, indirect-acting anticoagulants, sedatives, anticonvulsants, sulfonamides, cardiac glycosides, other broncholytics among the adrenomimetics, MAO inhibitors, calcium-containing drugs, vitamin D, mineral corticoids. α+β-adrenomimetics are incompatible with oral hypoglycemic agents, indirect-acting anticoagulants, sedatives, cardiac glycosides, sympatholytics, sulfonamides, diuretics, Doctor and insulins, myorelaxants, other broncholytics among the adrenomimetics, MAO inhibitors, calcium-containing drugs, -adrenoblockers, vitamin D, mineral corticoids. Adrenaline is incompatible with aminazine, penicillin, euphyllin, phenobarbitals, seduxen, sodium bromide, digitoxin, dicoumarin, dibazol, haloperidol. pharmacist, Mesatone is incompatible with acetylcholine, butamide, benzohexonium, phenobarbital, digitoxin, dicoumarin, magnesium sulfate, streptocide, seduxen, sodium bromide. remember! Isadrin is incompatible with butamide, phenobarbital, digitoxin, dicoumarin, streptocide, seduxen, diphenine, proserin. Halazoline isn’t prescribed for treating chronic rhinitis. Tetrizoline can increase IOP, BP. Its prolonged administration can cause the secondary edema of the nasal mucous membrane. Dobutamine solution is incompatible with 5% solution and other alkaline solutions in the same syringe. Ephedrine isn’t recommended before going to bed. Ephedrine is an ingredient of theophedrine, solutan, ephatin. Ephedrine causes addiction.

ADRENERGIC ANTAGONISTS

ADRENOBLOCKERS CLASSIFICATION SYMPATHO- 1- and 2*- 1+2- 1- 1+2- +- LYTICS ADRENOBLOCKERS ADRENOBLOCKERS ADRENOBLOCKERS ADRENOBLOCKERS ADRENOBLOCKERS 1. * 6. Pirroxan 10. (Corvitol) 14. 19. Labetalol (Albetol) 21. Octadine 2. Tamsulosine 7. Phentolamine 11. (Anapriline) 20. Proxodolol (Isobarin) (Omnik) 8. 12. (Sectral) 15. 22. Reserpine Drugs and their 3. Terazosine mesilate (Dihydergot) 13. Talinolol (Cordanum) (Trasicor) (Cornam) 9. 16. (Hylucor) synonyms 4. Prazosine (Sermion) 17. (Visken) (Adversuten) 18. (Corgard) 5. Doxazosine (Cardura) Decrease of noradrenaline Block of  - or  *- Block of  -,  - Block of  - Block of  -,  - Block of -, - 1 2 1 2 1 1 2 content in Mechanism of action adrenoceptors. adrenoceptors. adrenoceptors. adrenoceptors. adrenoceptors. presynaptic membrane. Pharmacological Hypotensive effect, peripheral vessels dilation (3-9,19-22); decrease of cardiac output (10-18); antianginal, antiarrhythmic effects (10-20); improvement of blood supply of the small pelvis organs, increase of (1); decrease of smooth muscles tone of urethra prostatic part (2,5); decrease of intraocular effects pressure (20).

Indications and Hypertension (3-15,17-22); IHD, tachyarrhythmia (10-18,20); hypertensive crisis (6,19,20); chronic heart failure (3); psychogenic impotency, urinary bladder atonia (1); adenoma (2-5); endarteritis (4-7); migraine (8,9); pheochromocytoma diagnostics (7); morphine and alcoholic abstinence (6); interchangeability glaucoma (20); motion sickness; skin (6). -adrenoblockers are incompatible with tricyclic antidepressants. -adrenoblockers are incompatible with narcotic analgesics, anticholinesterase agents, tricyclic antidepressants. +-adrenoblockers are incompatible with cardiac glycosides. Sympatholytics are incompatible with MAO inhibitors, adrenal corticoids, tricyclic antidepressants, cardiac glycosides, psychomotor stimulants. Doctor and Acebutolol is incompatible with antiarrhythmic drugs, quinidine, halogen-containing general anesthetics; drugs, containing . pharmacist, Propranolol mustn’t be used with tranquilizers, neuroleptics, ergotamine simultaneously. Oxprenolol is incompatible with digitoxin, proserin, promedol, streptocide, mesatone, caffeine, hydrochloric acid, isadrin, diphenine. remember! Adrenoblockers and sympatholytics can cause orthostatic collapse. Pirroxan decreases itch, abstinence and motion sickness symptoms. “Abolition” syndrome is characteristic for anapriline. Hypotensive effect of octadine develops after 2-4 days. Before meals: 9. After meals: 2,7,10,22.

HORMONAL DRUGS OF HYPOPHYSIS AND HYPOTHALAMUS

DRUGS, INFLUENCING THE HYPOPHYSIS DRUGS OF HYPOPHYSIS HORMONES SECRETION CLASSIFICATION HORMONE SECRETION HORMONE SECRETION ANTERIOR HYPOPHYSIS MIDDLE* AND POSTERIOR INDUCTORS (RELEASING INHIBITORS HORMONES HYPOPHYSIS HORMONES FACTORS) 1. Growth hormone-releasing 4. Octreotide (Sandostatin) 7. Corticotropin (ACTH) 12. Intermedin* factor (Somatoliberin) 5. (Danol) 8. Somatotropin (Norditropin) 13. Oxytocin 2. Prothyrelin 6. Bromocriptine (Parlodel) 9. Chorionic 14. Pituitrin Drugs and their synonyms 3. Gonadorelin (Choriogonine) 15. Adiurecrine 10. Menopausal gonadotropin 16. Desmopressin 11. Lactin

Stimulation of anterior hypophysis hormones secretion (1-3). Stimulation of peripheral endocrine glands secretion (7-11). Anti-inflammatory, antiallergic, immunosuppressive effects (7). Growth and body weight increase, anabolic effect (8). Promotion of ovaries development, follicles maturity; stimulation of spermatogenesis (10). Promotion of follicle transformation into yellow body (9). Stimulation of lactation during afterbirth Pharmacological effects period (11). Inhibition of growth hormone release by adenohypophysis in acromegalia patients; decrease of gastric juice, insulin secretion (4). Suppression of secretion (5). Decrease of and STH secretion by anterior hypophysis (6). Improvement of vision acuity, eyes adaptation to darkness (12). Stimulation of uterine contractions (13,14). Antidiuretic effect (15,16).

Diagnostics of endocrinopathies (1-3), secondary hypofunction of adrenal gland cortex, “abolition” syndrome (7); hypophysal nanism (8), Indications and in men and women, sterility (9,10); hypogalactia (11), acromegalia, endocrine tumors of gastro-entero-pancreatic system (4); benign interchangeability tumors of mammary gland (5), menstrual cycle disorders, female sterility, acromegalia (6); degenerative changes of retina (12), labour induction (13,14), insipid , enuresis (15,16); endometriosis (5).

Danazol is not prescribed with drugs, containing and . Danazol potentiates the effects of anticoagulants. Doctor and pharmacist, It is not recommended to use bromocriptine simultaneously with ergot drugs, , butyrophenones, phenothiazines. ACTH is incompatible with anticoagulants. remember! Oxytocin should be carefully used with adrenomimetics. Somatotropin, chorionic gonadotropin, ACTH are contraindicated for patients with oncological diseases. During meals: 6.

INSULINS

ANIMAL ORIGIN INSULINS HUMAN ORIGIN INSULINS MONOCOMPONENT MONOPEAK SHORT- MEDIUM- LONG-TERM SHORT- MEDIUM- LONG-TERM SHORT- LONG-TERM CLASSIFICATION TERM TERM ACTING TERM TERM ACTING TERM ACTING ACTING ACTING ONES ACTING ACTING ONES ACTING ONES ONES ONES ONES ONES ONES 1. Lispro- 3. Human 5. Crystalline 6. Neutral 7. Insulin 9. Crystalline 10. Neutral 11. Amino- insulin isophane human insulin- insulin for aminoquinurid insulin- soluble quinurid (Humalog) insulin zinc injections (B-insulin-S) suspension insulin insulin 2. Human suspension suspension (Monoinsulin (Ultralente) (Actrapid) 8. Amorphous (B-insulin) insulin for (Humulin) (Ultratard ) MK) Drugs and their insulin-zinc injections synonyms 4. Mixed suspension (Actrapid) human in- (Insulin – sulin-zinc semilente) suspension (Monotard)

Regulation of carbohydrate metabolism, promotion of glucose transport inside the cells and its assimilation by tissues; increase of glycogenesis, Mechanism of action and fatty acids synthesis.

Pharmacological effect HYPOGLYCEMIC EFFECT (1-11).

Indications and DIABETES MELLITUS (1-11), HYPERGLYCEMIC COMA (2,6,9). interchangeability

The choice of insulin, dose selection and the drug changing are carried out under a strict doctor’s control. The hypoglycemic effect of insulins may be increased by -adrenoblockers, non-selective -adrenoblockers, , methyldopa, MAO Doctor and pharmacist, inhibitors;and decreased by oral contraceptives, saluretics, nicotinic acid, isoniazide, glucocorticoids, heparin, tricyclic antidepressants. remember! The use of clonidine, reserpine and salicylates can cause both decrease and increase of insulin effects. The simultaneous intake of -adrenoblockers, reserpine, clonidine can disguise the hypoglycemic symptoms. Before meals: 1,2,6,10.

ORAL HYPOGLYCEMIC DRUGS

SULFONYLUREA DERIVATIVES BIGUANIDE CLASSIFICATION OTHER DRUGS 1st GENERATION 2nd GENERATION DERIVATIVES 1. (Bucarban) 3. (Maninyl) 6. Metformin (Siofor) 8. Acarbose (Glucobay) Drugs and their 2. (Butamide) 4. (Glurenorm) 7. Buformin (Glibutide) 9. Isodibute 5. Gliclaside (Diabetone) synonyms

Suppression of gluconeogenesis in liver, stimulation of lipolysis, Mechanism of action Stimulation of endogenic insulin production by -cells of the pancreas. increase of glucose utilization by peripheral tissues and decrease of glucose absorption in the .

Pharmacological Hypoglycemic (1-9), hypolipidemic (3,6,7), fibrinolytic (6,7), anorexigenic (6,7). effects

Indications and Type II diabetes (1-9). Type I diabetes in patients treated with insulin and suffering obesity (3,6,7). interchangeability Combined therapy of type I diabetes (8).

Oral hypoglycemic drugs are incompatible with -adrenomimetics, MAO inhibitors, psychomotor stimulants, hormones of adrenal gland cortex, - adrenomimetics, antiarrhythmic drugs. Sulfonylurea derivatives are incompatible with salicylates, , indirect-acting anticoagulants, butadion, levomycetin. They are carefully used together with -adrenoblockers. Doctor and pharmacist, Tolbutamide is incompatible with mesatone, caffeine, isadrin. remember! Acarbose effect decreases while taking together with cholestiramine, enzymatic agents, , intestinal adsorbents. Taking of sulfonylurea derivatives causes alcohol intolerance. Before meals: 3,5,8. After meals: 6. During meals: 4,6,7.

THYROID AND PARATHYROID HORMONAL DRUGS

THYROID DRUGS ANTITHYROID DRUGS PARATHYROID* DRUGS AND AGENTS CLASSIFICATION (MONOCOMPONENT, COMBINED* (THYREOSTATICS) AFFECTING CALCIUM METABOLISM ONES) 1. Thyroidine 6. Thiamazole (Merkazolyl) 8. Dihydrotachisterol (Tachistine) 2. Sodium- (L-thyroxine) 7. Propylthiouracil 9. Salmonis synthetic calcitonin (Miacalcik) Drugs and their synonyms 3. Liothyronine (Triiodothyronine) 10. Calcitonin (Calcitrin) 4. Thyreocomb* 11. Parathyroidine* 5. Thyreotom*

Increase of basal metabolism and energetic Inhibition of hormones Regulation of calcium and phosphorus metabolism, processes; stimulation of tissues growth and (thyroxine and triiodothyronine) increase of their content in blood (8,11). Inhibition of differentiation; increase of oxygen consumption Pharmacological effects synthesis. Inhibition of basal bone resorption, increase of calcium and phosphorus by tissues. metabolism. content in (9,10).

Indications and Hypothyroidism, myxedema, endemic goiter (1-5). Hypoparathyroidism, tetany, spasmophilia (8,11). Obesity (1). Cretinism (1,2). Thyroid (1-3). Hyperthyroidism (6,7). , hypercalcemia, slow fractures union interchangeability (9,10). Posttraumatic bone atrophy (9-11).

Thyroid drugs are incompatible with antibiotics. Dihydrotachisterol isn’t recommended to combine with calcium-containing drugs, parathyroid drugs, vitamins from D group. Levothyroxine and triiodothyronine effect can be increased by interaction with salicylates, ; and decreased – with carbamazepine, Doctor and pharmacist, . remember! Levothyroxine enforces effects of indirect-acting anticoagulants. Thiamazole, propylthiouracil shouldn’t be prescribed simultaneously with drugs, suppressing leukopoiesis. Before meals: 2,5. After meals: 1,6.

ADRENOCORTICOIDS AND THEIR SYNTHETIC ANALOGUES

GLUCOCORTICOIDS (GC) MINERAL COR- CLASSIFICATION GC FOR ORAL USE GC FOR GC FOR EXTERNAL COMBINED GC TICOIDS (MC) AND INJECTIONS INHALATIONS USE 1. 5. Budesonide 8. Budesonide (Apulien) 14. Aurobine 19. Ultralan 24. Deoxycorticosterone 2. Triamcinolone (Pulmicort) 9. 15. Dermasolone 20. Cortonitol acetate (DOCSA) 3. Mazipredone 6. Beclometasone (Kenalog) 16. Mycosolone 21. Prednicarb Drugs and their (Prednisolone) (Beclomet) 10. (Cortyl) 17. Ambene 22. Trimistine synonyms 4. 7. Flunisolide 11. Mazipredone (Depersolone) 18. Synalar-N 23. Canderm-BG (Inhacort) 12. Betamethasone (Cuteride) 13. Fluocinolone acetonide (Sinaflan) Binding to receptors of the target cells (GC, MC). Decrease of phospholipase A2, C; cyclooxygenase, lipooxygenase activity; inhibition of the macrophages differentiation; decrease of IgE-dependent histamine secretion from basophiles; suppression of fibroblasts proliferation; decrease of Mechanism of action proliferation and functions of T-lymphocytes; suppression of interleukin formation; influence on all types of metabolism (carbohydrate, lipid, water-salt) (GC). Influence on water-salt metabolism (MC). + Pharmacological Anti-inflammatory, antiallergic, immunosuppressive (1-23); antishock, antitoxic (1-4) effects. Retention of water, Na , Side effects: “” diabetes, “steroid” stomach ulceration, decrease of the adrenal gland functions, hypertension (1-4); Cl-; of K+ ions effects decrease of immunity (1-13). (24).

Rheumatoid arthritis (1-4,17). Acute pancreatitis, infectious hepatitis, hemolytic anemia (3,4). Glomerulonephritis, acute leukemia (1,3,4). Shock, organs Indications and transplantation (1-4). Bronchial asthma (1-7). Allergic , eczema, infectious-inflammatory skin diseases (1-4,8-13,15-16,18-23). (8-13,18-22). Neurodermatitis (1-4,9-13,18-23). interchangeability Mycoses of skin and nails (16,22,23). Gout, neuralgia, radiculitis (17). Haemorrhoids (14). Hypocorticism, Addison's disease, myasthenia (24). Adrenocorticoids are incompatible with oral hypoglycemic drugs, peripheral-acting muscle relaxants, sedatives, sympatholytics, , salicylates, hypotensive drugs, cardiac glycosides, coumarins, hormonal contraceptives, NSAIDs, barbiturates, prasiquantel. GC must be used only according to doctor’s indication: this group has many side effects. Simultaneous use of GC and dimedrol can cause decrease of GC effect and increase of IOP. Doctor and ointments are contraindicated in case of viral and mycotic skin diseases. pharmacist, Prednisolone is incompatible with barbiturates, gentamycin, papaverine h/chl., euphylline, seduxen, magnesium sulfate, sodium bromide, coagulants, remember! salicylates, diuretics. Methylprednisolone mustn’t be used during all types of vaccination and immunization. Triamcinolone mustn’t be taken in with barbiturates, rifampicin. Triamcinolone and isoprenaline simultaneous use can cause ventrical fibrillation. Hydrocortisone is incompatible with vitamin D. HORMONAL DRUGS OF GONADS AND ANABOLIC STEROIDS

ESTROGENS (STEROIDAL, CLASSIFICATION * ONES); GESTAGENS ANABOLIC STEROIDS ** 1. Ethinyl (Microfolline) 9. (Turinal) 14. propionate 19.Methandrostenolone 2. (Folliculine) 10. (Norkolute) 15. Testenate (Methandienone) 3. Estradiol 11. Progesterone 16. Tetrasterone (Sustanone- 20. phenylpropionate Drugs and their 4. (Ovestine) 12. Pregnine () 250) (Phenoboline) synonyms 5. Conjugated (Hormoplex) 13. Acetomepregenol 17. 21. (Retabolil) 6. Sinestrol* () 18. Testobromlecite 22. Silaboline 7. * 23.Methylandrostendiol 8. Clomiphene citrate** Mechanism of action Binding to the target cells receptors → influence on DNA and RNA synthesis → influence on the protein synthesis and functions. Induction of the endometrium proliferation, stimulation of the Decrease of the uterus Anabolic effect (stimulation of secondary sexual characters and uterus excitability and contractility, Formation of male genitals and protein synthesis, tissue regeneration, development, increase of uterine induction of secretory phase of secondary sexual characters osteogenesis). Increase of liver contractions (1-7). Increase of Pharmacological effects endometrium, stimulation of (androgenic effect); anabolic antitoxic function, erythropoiesis; gonadotropins secretion, stimulation of the mammary glands effect (14-18). retention of and phosphorus (in low doses), inhibition of development (9-13). in the body (19-23). gonadotropins secretion (in high doses). Antiestrogenic effect (8).

Amenorrhea, sterility (1-3,5-8); vaginal mucous membrane atrophy (4); genital Impotence, sterility, Uterine bleedings (10-13), Cachexia, dystrophy, osteoporosis, hypoplasia, labour induction (1-3,5-7); eunuchoidism, mammary gland Indications and threatened preterm labour (9- chronic infections, injuries, burns climacteric disorders (1-7); mammary and ovary tumors, climacteric 11,13); endometriosis (10); (19-23); myocardial infarction (19- interchangeability gland cancer (1,6-8); syndrome (14-18); uterine sterility, (11,12). 21). (1,6,7); dysfunctional uterine bleedings, bleedings (14,17). androgenic insufficiency in men (8). Estrogens are incompatible with indirect-acting anticoagulants. Doctor and pharmacist, Long-term administration of anabolic steroids causes androgenic effect. Retabolil should be carefully used with indirect-acting anticoagulants and oral hypoglycemic drugs. remember! Turinal isn’t recommended to use with drugs–inductors of microsomal liver enzymes. Before meals: 19. DRUGS AFFECTING MYOMETRIUM

DRUGS STIMULATING THE UTERINE CONTRACTILITY DRUGS INHIBITING THE UTERINE CLASSIFICATION () AGENTS INCREASING UTERINE AGENTS INCREASING CONTRACTILITY (TOCOLYTICS) CONTRACTIONS AND TONE PREFERABLY UTERINE TONE HORMONAL DRUGS OF HYPOPHYSIS ERGOT DRUGS 2- ADRENOMIMETICS 1. Oxytocin 11. maleate 19. Fenoterol (Partusisten) 2. Methyloxytocin 12. 20. Ritodrin (Pre-Par) 3. Desaminooxytocin 13. Ergotamine (Cornutamine) 21. Hexaprenaline (Gynepral) 4. Pituitrin 14. Ergotal 22. Salbutamol (Salbupart) ESTROGENIC DRUGS SYNTHETIC DRUGS 5. Estrone (Folliculine) 15. Cotarnine chloride (Stipticine) GESTAGENIC DRUGS Drugs and their synonyms 6. 23. Allylestrenol (Turinal) 7. Sigetine 24. Progesterone PROSTAGLANDINS PLANT ORIGIN DRUGS 8. Dinoprost (Prostin F2α, Ensaprost-F) 16. Shepherd’s purse herb 9. Dinoprostone (Prostin E2, Cerviprost) 17. Barberry leaves tincture 10. Prostenone (PGE2) GANGLIONIC BLOCKERS 18. Pachycarpine hydroiodide

Pharmacological effects Increase of uterine tone and contractions (1-15,18). Protection of uterine vessels’ walls (16-17). Inhibition of uterine contractions (19-24).

Indications and Labour induction (1-10); hypotonic uterine bleedings, involution of uterus after labour or abortion (1-4,11-15,18); treatment of intrauterine asphyxia (7); therapeutic abortion (8-10); climacterium, sterility, amenorrhea (5-7); stoppage of functional uterine bleedings and bleedings caused interchangeability by fibroma (16-17); prophylaxis and treatment of the threatened abortion or preterm labour (19-24); disorders of uteroplacental circulation (23,24).

Oxytocin, methylergometrine should be carefully used with sympathomimetics. Doctor and pharmacist, Desaminooxytocin isn’t prescribed with other drugs with oxytocin effects. remember! Fenoterol shouldn’t be used with calcium-containing drugs, vitamins of D group, mineral corticoids. Ritodrin should be carefully prescribed with glucocorticoids.

CONTRACEPTIVES

COMBINED ESTROGEN-GESTAGEN DRUGS CLASSIFICATION GESTAGEN MICRODOSES (MINI-PILLS) MONOPHASIC ONES DIPHASIC ONES TRIPHASIC ONES 1. Ovidone 10. Anteovin 12. Tri-regol 18. Continuin 2. Rigevidone 11. Neo-eunomin 13. Trizistone 19. (Ovret) 3. Minizistone 14. Triquilar 20. Microlute 4. Diane-35 15. Trinovum 21. Linestrenol (Exlutone) Drugs and their 5. Non-ovlone 16. Trinordiol–21 synonyms 6. Femoden 17. Milvane 7. Marvelone 8. Microgynone–28 9. Silest

”Cervical factor” – decrease of cervical mucosa secretion Central (direct) action – inhibition of the hypothalamus-pituitary system (inhibition of and change of its physicochemical properties. the FSH and LH production) and as a result inhibition of ovulation. “Uterine factor” – inhibition of the endometrium Mechanism of action Peripheral (mediated) action – influence on the ovaries, endometrium, cervix of the proliferation, interruption of the fetal ovum implantation. uterus, Fallopian tubes. “Tube factor” – inhibition of the uterine tubes motility.

Pharmacological effects Contraceptive (1-26); antiovulatory (1-24); antiandrogenic (4,6,9); antibacterial, antiseptic, , spermicidal (25,26) effects.

Contraception for women with estrogenic character phenotype (1,2); contraception, menstrual cycle disorders (3,10,13); contraception for young Indications and women (4,6,8,11-14,17); contraception for women with hyperandrogenism, treatment of , , androgenic alopecia (4,7,9); contraception interchangeability for women older than 35 years, suffering headache, thrombophlebitis (18-21); contraception during lactation (9,14,18-21,23-25); contraception for women, living irregular sexual life (22); endometriosis, contraception for women of all ages, prophylaxis of several venereal diseases (25,26).

Doctor and pharmacist, Oral contraceptives are incompatible with rifampicin, barbiturates, phenylbutazone, antibiotics with broad spectrum of action, sulfonamides, pyrazolone derivatives, analeptics, tranquilizers, anticonvulsants, drugs–inductors of microsomal liver enzymes, activated carbon, laxatives. remember! Minizistone, non-ovlone are incompatible with narcotic analgesics, oral hypoglycemic drugs.

CONTRACEPTIVES (CONTINUATION)

PROLONGED PROGESTIN-CONTAINING DRUGS POSTCOITAL VAGINAL CONTRACEPTIVES CLASSIFICATION SUBCUTANEOUS CONTRACEPTIVES ONES FOR (SPERMICIDES) IMPLANTS 22. 23. acetate 24. Levonorgestrel (Norplant) 25. Benzalkonium chloride (Pharmatex) (Postinor) (Depo-Provera) 26. Nonoxynol (Contraceptol, Patentex Oval) Drugs and their synonyms

Change of the normal Inhibition of gonadotropic hormones (FSH, LH) secretion from secretory phase of menstrual Damage of cell membrane → pituitary, increase of cervical mucosa viscosity, prevention of cycle, induction of fragmentation and death of Mechanism of action spermatozoons movement, interruption of fetal ovum implantation, temporary atrophic changes spermatozoons. suppression of ovulation. in ovaries.

Estrogen-dependent: Headache (1-11,14,16,17,21,23) Gestagen-dependent: Nausea, vomiting (1-3,5-7,9-11,14,16,18,19,22,23) Body weight increase (1,2,4-6,8,11,14,16,17,19,21,23) Gastrointestinal disorders (6,8,9,11,14,16,21) Depression, mood dropping (1,2,4-7,11,14,17,20,23) Side effects Pain in mammary glands (2-4,6-11,13,14,16,17,19,23) Libido dropping (4-6,8,11,14-17,20-21) Hypertension (1,2,5,7,9,10) Acne, alopecia (24) Thrombophlebitis (1,2,4,5,8,14,19,23) Intermenstrual bleedings (1,4,7,14-17,19,21,22) Chloasma (3,4,6-9,14,16,19) Allergy (7,23) Good tolerance (sometimes burning) (25,26)

Triphasic contraceptives are completely corresponding with physiological menstrual cycle; they ensure optimal doses with the minimal hormonal load on the women organism. Doctor and pharmacist, Diane-35, Milvane, Femoden, Microgynone–28 don’t influence on the puberty in period of menstrual cycle formation. remember! Pharmatex doesn’t influence on the normal vaginal microflora and hormonal cycle. Depo-Provera is used as intramuscular injections 1 time in 3-6 months. Norplant is implanted under the forearm skin for 5 years.

VITAMIN DRUGS

DRUGS OF FAT- CLASSIFICATION DRUGS OF WATER-SOLUBLE VITAMINS MULTIVITAMIN DRUGS SOLUBLE VITAMINS 1. Thiamine chloride (B1) 7. Folic acid (Bc) 13. Retinol (A) 17. Vitrum 27. Pexvital 2. Riboflavin (B2) 8. Ascorbic acid (C) 14. Ergocalciferol (D) 18. Hexavit 28. Picovit 3. Calcium pantothenate (B3) 9. Nicotinic acid (PP) 15. Tocoferol acetate (E) 19. Gerovital 29. Pregnavit 4. Pyridoxine chloride (B6) 10. Rutin (P) 16. Vicasol (K) 20. Decamevit 30. Revit Drugs and their 5. Cyanocobalamine (B12) 11. Pyridoxal phosphate 21. Calcinova 31. Supradin synonyms 6. Calcium pangamate (B15) 12. 22. Lecovit C-Ca 32. Taxofit (Calgam) 23. Macrovit 33. Triovit 24. Mineravit 34. Undevit 25. Multitabs 35. Centrum 26. Oligovit 36. Unicap Participation in the rhodopsin formation (2,13,15); regulation of trophic processes in skin (9,13,15); influence on the nerve impulse conduction (1-5); cardiotrophic effect (1,4,11,12,15); participation in protein, lipid, carbohydrate metabolism, redox processes (1-3,5-8,10,12); stimulation of Pharmacological effects haemopoiesis (4,5,7); participation in blood coagulation (16); normalization of vascular wall permeability (8,10,15); antioxidant effect (8,10,13,15); regulation of the phosphoric and calcium metabolism (13,14); participation in tissue regeneration (8,13,15).

Indications and Hypovitaminosis (1-36); skin diseases (1-6,13,15); vision disorders (2,13,15); rickets (13,14); liver diseases (1,3-6,8,9,15,16); neuritis, neuralgia (1,3- 5); peptic ulcer, gastritis (1,3,9,10,13); radiation sickness, leukemia (2,5,7,10); anemia (4,5,7); hemorrhagic diathesis, bleedings (8,10,16); gonad interchangeability dysfunction (15); ischemic heart disease (1,4,9,12); chronic heart failure (1,4,7,11,12). Vitamin A is incompatible with hydrochloric and acetylsalicylic acids. Vitamin B1 is incompatible with vitamins PP, C, B12, B6; salicylates, tetracycline, sympathomimetics, hydrocortisone. Vitamin B2 is incompatible with vitamin B12. Vitamin B6 is incompatible with vitamins B1, B12; aminophylline, caffeine. Vitamin B12 is incompatible with aminazine, vitamin B1, hydrochloric and acetylsalicylic acids, vitamins PP, C, B6, B2; gentamycin. Vitamin C is incompatible with vitamins B1, B12; aminophylline, dimedrol, dibasol, salicylates, tetracycline, sympathomimetics, hydrocortisone, penicillin, iron-containing drugs, heparin, indirect-acting anticoagulants. Doctor and pharmacist, Vitamin D is incompatible with hydrochloric acid, vitamin E, salicylates, tetracycline, hydrocortisone. Vitamin PP is incompatible with vitamins B1, B12, B6; aminophylline, salicylates, tetracycline, sympathomimetics, hydrocortisone. remember! Vitamins mustn’t be injected with each other in one syringe. Vitamin B1 solution mustn’t be injected with solutions containing sulfites in one syringe. Vitamins B1, B6, B12 change the metabolism of each other, that’s why they mustn’t be used simultaneously. Vitamin A should be carefully used by patients with nephritis, heart diseases, . Prolonged vitamin PP intake can cause the fatty liver degeneration. Folic acid is incompatible with sulfonamides. Before meals: 30. After meals: 8,9,11-14,18. ENZYMATIC DRUGS

PROTEOLYTIC FIBRINOLYTIC AGENTS IMPROVING DIFFERENT ENZYMATIC CLASSIFICATION DRUGS DRUGS DIGESTION DRUGS 1. Tripsin 7. Fibrinolysin 10. Pepsin 15. Pansinorm 19. Hyaluronidase (Lidase) 2. Chimotripsin 8. Streptokinase 11. Gastric juice 16. Festal 20. Ronidase 3. Ribonuclease 9. Streptodecase 12. Abomin 17. Mezim-forte 21. Cytochrome C (Lecosim) Drugs and their synonyms 4. Deoxyribonuclease 13. Pancreatin 18. Ensistal 22. Penicillinase (Neuropen) 5. Collagenase 14. Solizym 6. Iruxol Decrease of hyaluronic acid viscosity → Destruction of peptide Transformation of increase of tissues permeability (19,20); Improvement of fats, proteins and bonds in the of profibrinolysin into improvement of tissue respiration (21); Mechanism of action carbohydrates digestion. proteins and peptides. active fibrinolysin. destruction of β-lactam ring of penicillin (22). Softening of scars, removal of contractures Thinning of the viscous in , lysis of hematomas (19,20); secretions, exudates, Dissolution of the restoration of oxidative processes in the Pharmacological effects blood clots; lysis of the newly-formed Improvement of digestion. body (21), elimination of symptoms caused necrotized tissue (1-6). thrombus, blood clots. by the allergic reactions and anaphylactic Antiviral effect (4). shock as a response to penicillin drugs (inactivation of penicillins) (22). Relief of sputum Newly-formed Contractures of joints, burn and surgery expectoration (1-3); burns, thrombus, recent scars, hematomas (19,20); rheumatic Pancreatitis (13-18), digestion dysfunctions: intertrigoes, frostbites, myocardial infarction, arthritis (19); postnatal asphyxia, chronic Indications and bedsores, purulent wounds achylia (11, 13, 14, 17), hypo- and anacid thromboembolism of , heart failure, ischemic heart (1-6); chronic commissural gastritis (10-17), dyspepsia (10-12, 15-18); interchangeability the pulmonary artery, disease, hypoxic states (21); acute allergic processes (1-3,6); hepatites, cholecystites (14, 15). iridocyclites (1,2); keratites, acute thrombophlebitis reactions and anaphylactic shock caused by conjunctivites (4). (7-9). penicillin drugs (22). Collagenase shouldn’t be combined with tetracyclines, heparin. Doctor and pharmacist, Anticoagulants should be taken not earlier than in 4 hours after streptokinase infusion. Chimotripsin is only for local application. remember! After meals:11,14,16. During meals:11,12,14-16.

DRUGS, DECREASING BLOOD COAGULATION

DIRECT-ACTING ANTICOAGULANTS CLASSIFICATION INDIRECT-ACTING ANTICOAGULANTS RESORPTIVE-ACTING AGENTS LOCAL-ACTING AGENTS 1. Heparin 5. Heparin ointment 8. Ethylbiscumacetate (Pelentan, Neodicoumarine) 2. Calcium nadroparin (Fraxiparin) 6. Hirudoid 9. Acenocumarol (Sincumar) 3. Sodium enoxaparin (Clexan) 7. Venitan 10. Phenindion (Pheniline) Drugs and their synonyms 4. Sodium reviparin (Clivarin)

Interaction of negative charged drugs with positive charged proteins of blood coagulation Inhibition of biosynthesis of blood coagulation system system → formation of ionic complexes → inhibition of blood coagulation at different Mechanism of action factors in liver. stages.

Inhibition of coagulation at all stages, activation of fibrinolysis, hypolipidemic effect, Decrease of blood coagulation, increase of the vascular improvement of the renal and coronary blood flow (1-4). Decrease of the Pharmacological effects permeability, hypolipidemic effect. aggregation (1-7). Immunosuppressive effect (1).

Embolism and thromboses of cerebral, pulmonary, ocular vessels; rheumatism, bronchial asthma, glomerulonephritis, hemolytic anemia, renal Thrombophlebitis, Indications and Prophylaxis and treatment of thromboses, embolism, transplantation, atherosclerosis, coronarosclerosis, haemorrhoids, venothrombosis, thrombophlebitis, strokes, coronary deficiency (8-10). interchangeability angina pectoris, hypertension, endocarditis (1-4). trophic ulcers of legs (5-7). Cardiac infarction, direct blood transfusion, surgeries on heart and vessels (1).

Direct-acting anticoagulants are incompatible with ACTH, antihistamine drugs, penicillin, tetracycline, papaverin, haloperidol, tricyclic antidepressants, digitalis drugs, strophanthin, mercuric diuretics, derivatives, . Indirect-acting anticoagulants are incompatible with - and -adrenomimetics, tricyclic antidepressants, estrogens, salicylates, diphenine, butamide, glucocorticoids, antiaggregants, barbiturates. Doctor and pharmacist, Heparin is incompatible with muscle relaxants. Heparin solution is incompatible with alkaline solutions, thyroxine, ACTH, protamine sulfate, antiaggregants, NSAIDs in one syringe. remember! During the heparin administration there is a risk of severe hemorrhages appearance. Heparin antagonist is protamine sulfate. Sodium enoxaparin musn’t be mixed with other drugs in one syringe. Indirect-acting anticoagulants can cause severe bleedings, both because of coagulation decrease and vascular dilatation. Treatment by indirect-acting anticoagulants should be stopped gradually. DRUGS DECREASING BLOOD COAGULATION (CONTINUATION)

FIBRINOLYSIS ACTIVATORS CLASSIFICATION ANTIAGGREGANTS (FIBRINOLYTICS) 1. Fibrinolysin (Plasmin) 4. Indobuphen (Ibustrine) 7. (Ticlid) 2. Streptokinase (Avelysin) 5. Dipyridamol (Curantil) 8. Acetylsalicylic acid (Aspirin) Drugs and their synonyms 3. Alteplase (Actilyse) 6. Clopidogrel (Plavix) 9. Cardacet (Propranolol + acetylsalicylic acid)

Activation of the adenylate Inhibition of the binding of fibrinogen to activated platelets Convertion of profibrinolysin into active cyclase (4,5). Stimulation of the by interaction with glycopeptide II / III (7). Inhibition of fibrinolysin (2). Activation of fibrin lysis in B A Mechanism of action E , D and cyclooxygenase inside the platelets and synthesis of clots (1-3). 1 2 formation (4,6). thromboxane (8,9). Block of 1- and 2-adrenoceptors (9).

Inhibition of the platelets and erythrocytes aggregation and adhesion, normalization of the blood Pharmacological effects Fibrinolytic effect (1-3). rheologic properties, improvement of cerebral, myocardial, retina microcirculation (4-9). Decrease of oxygen consumption by myocardium, antiarrhythmic effect (9).

Indications and Thrombosis of veins, arteries; fresh cardiac Prophylaxis and treatment of hypercoagulation syndrome, chronic coronary deficiency (4-9). infarction, thromboemdolism of pulmonary Ischemic encephalopathy, retinopathy (4-8). Stable angina treatment, cardiac infarction interchangeability artery (1-3). prophylaxis and treatment (in subacute period without blood circulation deficiency) (9).

Fibrinolytics are used in fresh (up to 5 days) thromboses with anticoagulants under the strict control of blood coagulation markers. Fibinolytics are contraindicated in case of bleedings, peptic ulcer, radiation sickness, tuberculosis. Fibrinolysin has marked antigenic properties. Doctor and pharmacist, Dipyridamol mustn’t be mixed with other drugs in one syringe. Dipyridamol’s effect decreases in case of caffeine and other derivatives influence. remember! There is tissue irritation in case of curantil subcutaneous penetration. Before meals: 5. After meals: 4,8. During meals: 7.

DRUGS INCREASING BLOOD COAGULATION

COAGULANTS OF HEMOSTATIC DRUGS (RESORPTIVE-ACTING, CLASSIFICATION FIBRINOLYSIS INHIBITORS SYNTHETIC, ANIMAL* LOCAL-ACTING* ONES) AND PLANT** ORIGIN 1. Aminocapronic acid (Amicar) 4. Fibrinogen 8. Thrombin* 10. Gelatinol* 2. Tranexamic acid (Transamcha) 5. Calcium chloride 9. Hemostatic sponge* 11. Carbasochrome (Adroxone) 3. Aminomethylbenzoic acid (Amben) 6. Menadion (Vicasol) 12. Water pepper herb** Drugs and their synonyms 7. Etamsylate (Dicinone) 13. Nettle herb**

Block of the plasminogen activation, Participation in blood coagulation as natural components of Decrease of the vascular wall Mechanism of action inhibition of plasmin functions, kinin the coagulation system (4,5,6,8,9). Activation of the permeability (11-13). Increase of systems and fibrinolysis (1-3). thromboplastin formation (7). the blood viscosity (10).

Pharmacological effect HEMOSTATIC EFFECT (1-13).

Acute fibrinolysis, local (nasal bleeding, tonsillectomy, tooth extraction, etc.) Massive bleedings in surgery, , traumatology due to Indications and fibrinolytic bleedings (1-3); Hemorrhagic diathesis, nasal and fibrinogen (4) and prothrombin (5-8) deficiency. All types of thrombocytopenia (1,3); bleedings in peptic uterine bleedings (7,10-13). interchangeability chronic hemorrhages: capillary and parenchymatous (7-9,11). ulcer and after labor (1,2); acute pancreatitis (1).

Aminocapronic acid should be given under the coagulogramm’s control. Tranexamic acid solution mustn’t be mixed with solutions containing penicillin, blood products in one syringe. Doctor and pharmacist, Dicinone shouldn’t be mixed with other drugs in the syringe. Thrombin solution mustn’t be injected intramuscularly and intravenously; it is used only locally to the wound. remember! Plant origin coagulants have mild anti-inflammatory effect. Fibrinogen solution is used only for an hour after its preparation. After meals: 5.

DRUGS AFFECTING ERYTHROPOIESIS AND LEUKOPOIESIS

ERYTHROPOIESIS STIMULANTS LEUKOPOIESIS STIMULANTS AND CLASSIFICATION COLONY-STIMULATING FACTORS* IRON-CONTAINING DRUGS VITAMINS, ERYTHROPOIETINS*

1. Iron fumarate (Ferronat) 6. Cyanocobalamin (vitamin B12) 10. Filgrastim* (Neypogen) 2. Gectofer (Ectofer) 7. Folic acid (vitamin Bc) 11. Lenograstim* (Granocyte) 3. Iron sulfate (Ferro-gradumet, 8. Coamid 12. Sodium nucleinate (Polydan) Drugs and their Tardiferon) 9. Human erythropoietin* (Epomax) 13. Ethyl-carboxyphenyl-thiazolidin-acetate synonyms 4. Iron dextran (Ferrolec-plus) (Leukogen) 5. Iron saccharate (Ferrum Lek) 14. Methyl-oxymethyluracyl (Pentoxyl) 15. Molgramostim* (Leukomax)

Stimulation of hemopoietic activity of the bone marrow Increase of hemoglobin content in Improvement of iron utilization and stimulation and leucopoiesis; increase of macrophages, Pharmacological effects erythrocytes (1-5). of hemoglobin synthesis (6-9). thrombocytes, eosinophiles number (10,11,15); acceleration of regeneration processes (12-14).

Leukopenia, agranulocytosis (12-14); immunity Hypochromic and hyperchromic anemia, decrease, radiation sickness (10-12,15); viral hepatitis Indications and hepatitis, hepatic , helminthiasis, states Iron-deficiency anemia (1-5). (10, 12-15), bone marrow transplantation (10,15), after stomach resection (6-8). Anemia in chronic interchangeability of malignant tumors (10,11,15), HIV- renal failure (9). infection (10-15).

Iron-containing drugs are incompatible with salicylates, cardiac glycosides, antacids. Folic acid is incompatible with sulfonamides. Doctor and pharmacist, Iron-containing drugs are incompatible with tetracyclines. Vitamin B12 (cyanocobalamin) mustn’t be injected with other drugs in the one syringe. remember! Iron-containing drugs cause , staining of excrements and teeth in black color (after taking in these drugs one should rinse the mouth). Leukopoiesis inhibitors are mainly antitumoral drugs. Erythropoiesis inhibitor is solution of sodium phosphate marked with phosphorus isotope (P32).

ANTITUMOR DRUGS

CLASSIFICATION ALKYLATING AGENTS CHLORETHYLAMINES ETHYLENIMINES DISULFONIC NITROSOUREA METALORGANIC ACIDS ESTERS DERIVATIVES AGENTS 1. Iphosphamide (Choloxan) 8. Thiophosphamide (Thioteph) 13. Myelobromol 15. Lomustine 20. Carboplatin 2. Dopan 9. Benzoteph 14. Myelosan 16. Carmustine 21. Cisplatin 3. Lophenal 10. Imiphos (Marcophan) 17. Nimustine (Nidran) (Platinol, Drugs and their synonyms 4. Novembichinum 11. Phosphemide 18. Fotemustine Platidiam) 5. Melphalan (Alkeran) (Phosphasine) (Mustoforan) 6. Chlorambucil (Leukeran) 12. Fotrin 19. Nitrosomethylurea 7. (Cyclophosphan) Alkylation of molecules in cells, inhibition of protein synthesis, formation of transversal bonds between DNA and RNA (inhibition of cell division Mechanism of action ability: damage of mitochondrial membrane, separation of the processes of oxydation and phosphorylation, irreversible damage of the tumor cells’ structure and functions in any functional stage).

CLASSIFICATION ALKALOIDS PERIWINCLE PLANT AUTUMN CROCUS*, FOLIC ACID*, **, MAY- ONES ONES (VINCA YEW-TREE ANALOGUES () ALKALOIDS) (TAXANS) ONES 22. Methotrexate* 29. Hemcytabine (Hemsar) 34. Vinblastine 38. Etoposide 42. Colchamin* 23. Edatrexate* 30. Fluorafur (Rosevine) 39. Teniposide (Vumone) 43. (Taxol) Drugs and their synonyms 24. Mercaptopurine** 31. Fluoruracil 35. Vincristine 40. Podophyllin 44. 25. Fopurine** 32. Fludarabine phosphate** (Oncovine) 41. Etoposide phosphate (Taxoter) 26. Pentostatin** (Nipent) 33. UFT ( + fluorafur) 36. Vinorelbine (Etopose) 27. Thioguanine** (Lanvis) (Navelbine) 28. Cytarabine (Cytosar) 37. Vindesine (Eldisine) Antagonism to natural , interruption of DNA and Inhibition of tumor cells division at the different stages of mitosis. (These agents RNA synthesis in the tumor cells by blocking the basic Mechanism of action are mitotic poisons). enzymatic processes.

Pharmacological effects Antitumor (1-75); cytostatic, cytotoxic, immunosuppressive (1-44) effects. ANTITUMOR DRUGS (CONTINUATION)

HORMONAL AND ANTIHORMONAL DRUGS ADRENO- CLASSIFICATION LUTEINIZING ANTIAND- CORTICOIDS GESTAGENS ESTROGENS ANTIESTROGENS ANDROGENS HORMONE ROGENS BIOSYNTHESIS AGONISTS INHIBITORS 45. 48. Polyestradiol 53. 55. Testosterone 57. 60. 63. Amino- (Megeyse) phosphate (Mammofen) propionate (Anandrone) (Zolagex) 46. Medroxipro- (Estradurine) 54. Toremifen 56. Nandrolone 58. 61. Buserelin (Mammomit) Drugs and their gesterone acetate 49. Phosphestrol (Farestone) (Flucinome) (Suprefact) 64. Chloditan synonyms (Depo-Provera) (Chonvane) 59. Cyprotero- 62. Leuprolid (Mitotan) 47. Gestonorone 50. Chlortrianizen ne acetate (Prostap) caproate 51. (Androcur) (Depostat) 52.

Inhibition of gonadotropins production, resulting in inhibition of estrogens synthesis (45-47); inhibition of growth of hormone-dependent tumors in Mechanism of action target-tissues (48-52,55-56); blocking of hormonopoietic function of the testicles and ovaries (that is pharmacological castration) (60-62); competitive binding to the estrogen (53,54), (57-59) receptors; inhibition of adrenocorticoids biosynthesis (63-64).

Pharmacological Antiandrogenic (48-52,57-59); androgenic (55,56); estrogenic (48-52); antiestrogenic (45-47,53,54,63,64) effects; pharmacological castration (60-62). effects

Nausea (1-47,53,54,57-59,61-65,68-70,72,73,75); lack of appetite, diarrhea, vomiting (1-44); stomatitis (5-8,15-20,22,24,26-35,37-44); myalgia (43,44); neuropathy (20,35,36); bronchospasm (29); hyperpigmentation of skin (17,65); phlebitis (16); hemorrhagic cystitis (1,7); water retention (45- 52,57-59); increase of body weight (45-47); hypercoagulation (45-52); hot flushes (16,57-63,67); (hirsutism, voice changes, acne) (55,56); Side effects (45-52,57-59); metrorrhagia (48-56); hypercalcemia (48-54); inhibition of bone marrow function (2,5,6,8,14- 16,19,21,24,27,28,31,65,66); cardiotoxicity (7,29,69,70-73); gastrointestinal tract ulceration (22,31,65,67,69,70,72); hepatotoxicity (22,24,53,58,59,65); nephropathy (1,5-7,14,22,24,27,28,34,35,72); myelosuppression (4,25,26,30,65,66,70,72,73,75); hyperglycemia (68); fever (67,70,75); alopecia (65,69,70-72,75); nephrotoxicity (1,15,16,21,68).

ANTITUMOR DRUGS (CONTINUATION)

CLASSIFICATION ANTITUMOR ANTIBIOTICS TOPOISOMERASE I INHIBITORS ACTINOMYCINS ANTHRACYCLINES 74. Topotecan 65. Dactinomycin (Cosmegen) 69. Doxorubicin (Doxolem) 75. Irinotecan (Campto) Drugs and their synonyms 66. Mytomycin (Mytolem) 70. Mitoxanthrone (Trexan) 67. Bleomycin (Bleo) 71. Epirubicin (Pharmarubicin) 68. Streptozocin (Zanozar) 72. Rubomycin 73. Carminomycin Intercalation between the DNA threads, inhibition of DNA-dependent RNA synthesis (65,66,69,70,72,73); production of free radicals, which Mechanism of action provoke DNA disruption and damage of cell membranes (67,68,71); inhibition of topoisomerase I (74,75).

Pharmacological effects Cytostatic, cytotoxic, immunosuppressive (65-75); antimicrobial (65-73) effects.

Leukemias (1-3,6-8,11-14,19,22,24-28,32,34,35,37-39,41,66,69-71,72) Erythremia (10) Uterus carcinoma (1,7,20-22,24,31,33,35,45-47,53-55,65-67,69,71,75) Ovarian carcinoma (1,3,5-9,12,20-22,31,33,34,43-47,53-55,65,67,69) Stomach carcinoma (15,16,21,30,31,38,41,65-67,69,75) Prostate carcinoma (7,21,22,31,48-64,67,69) Mammary gland carcinoma (1,2,5,7-9,15,21-23,30,31,34-37,43-47,50, 53- Sarcoma (1,4,5-8,16,21,22,34,35,37,38,41,65,67,69,73) 56,63,66,69,70,73) Urinary bladder carcinoma (7,8,20-22,31,34,35,38,39,41,66,69) Lung carcinoma (1,4,7,8,15,17,19,20-22,23,29,31,34-38,39,41,43,44, Skin cancer (42,67,68,70) 66,67,69,70,71,73-75) Pancreas carcinoma (1,29,31,66,68,69) Lymphogranulomatosis (2-4,6-8,15,16,19,21,28,34,35,38,41, Liver carcinoma (16,22,31,69,70,72) Indications and 65,67,69,73) Testicle carcinoma (1,5-7,20-22,34,38,41,65,67) interchangeability Cerebral tumor (5,15-18,30,34,35,39,67,68,70,71,74,75) Renal carcinoma, renal carcinosarcoma (Wilms’ tumor) (7,15,22,34,35,41,65,67, Melanoma (5,15-19,35,37,65) 69,71,72) and cancer, colorectal carcinoma (22,30,31,35,66- Head and neck carcinoma (20-22,31,34,35,37,44,66,67,69,74) 68,75) Adrenal cortex carcinoma (21,63,64) Esophageal carcinoma (17,22,37,40,67) Ewing’s tumor (1,7,35,38,41,65,72) Penis carcinoma (67) Multiple myeloma (5,7,15,16,22,35,69) Thyroid gland carcinoma (5,67,69)

One should avoid to use simultaneously melphalan and nalidixic acid. Myelobromol is incompatible with other antitumor drugs and radiation therapy. Carboplatin is incompatible with drugs, causing myelosuppressive, nephro- and neurotoxic effects. Doctor and pharmacist, Vinblastine shouldn’t be mixed with drugs, having the pH beyond the bounds of 3,5-5, in one syringe. Vincristine solution is incompatible with furosemide solution in one syringe. remember! Nimustine, etoposide, trexan solutions mustn’t be mixed with other drugs’ solutions in one syringe. Phosphestrol mustn’t be mixed with solutions, containing calcium and magnesium salts, in one syringe. Epirubicin shouldn’t be mixed with heparin solution, other antitumor drugs in one syringe. After meals: 2,3.

ANTIULCER DRUGS

ANTACID AND REPARATIVE, H -HISTAMINOBLOCKERS, 2 COVERING AGENTS ASTRINGENT COMBINED* AND ANTIHELICOBACTERIAL M -CHOLINOBLOCKERS*, CLASSIFICATION 1 (MONOCOMPONENT, AGENTS OTHER** ANTIULCER DRUGS H+/K+-ATPase INHIBITORS** COMBINED*) DRUGS 1. (Quamatel) 6. 10. Bismuth 12. (Saytotec) 18. Metronidazole 2. (Primamet) (Phosphalugel) subcitrate (De-nol) 13. Methyluracil (Trichopol) Drugs and their 3. (Ranital) 7. Carbaldrate (Alugastrin) 11. Sucralfate 14. Vicair* 19. Helicocin 4. Pirenzepine* (Gastrocepine) 8. Maalox* (Venter) 15. Gastropharm* 20. Bismuth-containing drugs synonyms 5. ** (Omez) 9. Alumag* 16. Liquiritone* 17. Plantaglucide**

Formation of albuminates Neutralization of the Block of H -histamine (1-3), M - (protection of the 2 1 hydrochloric acid in Stimulation of regenerative cholinoceptors (4) of gastric gastric mucous Bactericidal effect on stomach, covering of the processes in stomach (12, Mechanism of action mucous membrane. Block of membrane); Helicobacter pylori (18-20). stomach mucous membrane 13). H+/K+-ATPase enzyme (5). bactericidal effect (6-9). on Helicobacter pylori (10-11). Gastroprotective, Gastroprotective, antisecretory (12-13); Antisecretory (hydrochloric acid, Covering, (6-9) antibacterial, astringent, antacid (14-16); pepsine) (1-5); spasmolytic (4); Antibacterial (18-20) effect. Pharmacological effects effects. astringent (10-11) spasmolytic, anti- gastroprotective (5) effects. effects. inflammatory (14-17) effects. Indications and Peptic ulcer (1-20); hyperacid gastritis (1-16, 18-20); hypoacid gastritis (17); gastroesophageal reflux, Zollinger – Ellison’s syndrome (1-5). interchangeability Antacids are incompatible with iron salts. Antacids should be taken 1,5-2 hours before or 1,5-2 hours after taking other drugs. Cimetidine must not be taken together with benzodiazepines, oral anticoagulants, propranolol, , cytostatics and hemopoiesis inhibitors. Doctor and pharmacist, Sucralfate must not be taken with tetracycline. The prolonged administration of De-nol and Venter results in scarry deformations of the stomach and duodenum. remember! + + H2-histaminoceptors, M1-cholinoceptors, H /K -ATPase are responsible for the hydrochloric acid production by gastric mucous membrane. Before meals: 1-5,7,9-11,17,20. After meals: 8,13,14,18,19. During meals: 12,13,18,19. l HEPATOPROTECTORS

DRUGS, CONTAINING ANIMAL AMINOACIDS AND SYNTHETIC HOMEOPATHIC CLASSIFICATION PLANT ORIGIN DRUGS ORIGIN ESSENTIAL DRUGS DRUGS DRUGS PHOSPHOLIPIDS* 1. Silibinine 6. Apcosul 11. Sirepar 16. Ademethionine (Heptral) 24. Antral 33. Galstena (Carsil, 7. Hepabene 12. Trophopar 17. Ornitine (Hepa-Merz) 25. Thiotriazoline 34. Hepar Legalon) 8. Liv 52 13. Vigeratin 18. Hepasteril A 26. Betaine citrate compositum 2. Bilignine 9. Hepatophalc 14. Vitohepat 19. Hepasteril B 27. Malotilate 35. Hepel 3. Simepar Planta 15. Erbisol 20. Hepasol (Maximalone) 4. Tiqueol 10. Solyaren 21. Glutarsine 28. Thiazolidine Drugs and their synonyms 5. Cinarine 22. Essentiale* (Heparegen) (Angirol) 23. Phospholip* 29. Epargrizeovit 30. Catergen 31. Zixorine 32. Ursodeoxycholic acid Normalization of metabolic processes in hepatocytes; stabilization of hepatocytes cell membranes; decrease of free radical oxidation processes in Mechanism of action hepatocytes. Hepatoprotective (1-35) Spasmolytic (7,9,35) Antiulcer (4, 15) Antioxidant (1,7,9,15,24,25,30) Antimicrobial (9) Antianemic (14) Antitoxic (1,5,6,9-11, 15,19,21,22,31,34) Cholelitholytic (10,32) Cardioprotective (22,25) Choleretic (2,4,5,7,9,10,24,25, 31,35) Immunomodulating (15,24) Pharmacological effects Anabolic (25,29) Membrane-stabilizing (1,4,6,7,9,22,24,25,30,32) Anti-inflammatory (1,4,10,15,24) Antipyretic (24) Regenerative (7-9,11,29,35) Antidepressant (16) Antianorectic (6,8). Analgesic (9,24) Diuretic, laxative (8) Chronic hepatitis (1-5,8,9,11-14,17-19,22,24,25,28,30-32,34) Cholestatic hepatitis (2,16,35) Hepatic cirrhosis (1-3,8,11,12,16,18,20,22-24,27-29,30-32) Hypoacid gastritis (13,14) Acute hepatitis (8,9,12,17-19,24,29,33) Indications and Renal failure (5) Cholecystitis (4,5,9,33,34) Hypercholesterolemia (26,34) interchangeability Biliary dyskinesia (4,5,7,9) Peptic ulcer (4) Hepatic coma (18-21) Anemia (14). Pancreatitis (13,33) Doctor and pharmacist, In order to prepare Essentiale solution for intravenous injection, one mustn’t use solutions. Heptral isn’t recommended to use before bedtime, because of its tonic effect. remember! Before meals: 1,2,4. After meals: 4,17,24. During meals: 7,22. LAXATIVE DRUGS

DRUGS DRUGS REFLEX DRUGS WITH DRUGS INCREASING STIMULATING CLASSIFICATION OSMOTIC SOFTENING VOLUME OF COMBINED DRUGS INTESTINAL PROPERTIES FECES INTESTINAL PERISTALSIS CONTENTS 1. (Dulcolax) 7. 11. Vaseline oil 12.Sea- (Laminarid) 13.Agiolax 2. (Portalac) (Guttalax) 8. 3. Plantex (Forlax) Drugs and their synonyms 4. Sennosides A, B 9. Magnesium (Regulax, Sennadexin) sulfate 5. Buckthorn bark 10. Carlovar salt 6. Increase of osmotic Irritation of intestinal Mechanical stimulation of Depending on the drug pressure in Feces softening. Mechanism of action receptors. intestinal receptors. components. intestine.

Pharmacological effect LAXATIVE (1-13) EFFECT.

Constipations as a result of intestinal hypotonia and weak intestinal peristalsis (1-13). Indications and Stool regulation in hemorrhoid, proctitis and anal fissures (1, 2, 5, 7, 13). interchangeability Correction of digestion disorders in children (3). Preparation for surgeries, instrumental and X-ray examinations (1,2).

Administration of sodium picosulfate with antibiotics can cause decrease of laxative effect. Forlax doesn’t contain sugar; it can be prescribed to diabetic patients. Doctor and pharmacist, Laminarid is incompatible with iodine-containing drugs. remember! Agiolax is not recommended to use together with other laxatives. Before meals: 4,9,10. After meals: 13.

DIURETIC DRUGS

CLASSIFICATION DIURETICS LOOP DIURETICS CARBOANHYDRASE INHIBITORS

1. (Dichlothiazide, 4. Furosemide (Lasix) 10. (Diacarb, Phonurite) Hypothiazide) 5. (Buphenox) 2. Chlorthalidone (Hyhrotone, Oxodoline) 6. Clopamide (Brinaldix) Drugs and their synonyms 3. Cyclomethiazide 7. Ethacrynic acid (Uregit) 8. Indapamide (Ariphone) 9. Pyretanide (Arelix)

Inhibition of Na+, Cl-, K+ ions and water Inhibition of Na+, Cl-, K+ ions and water Inhibition of carboanhydrase enzyme in proximal reabsorption preferably in distal part of the Mechanism of action reabsorption in Henle’s loop. part of nephron’s convoluted tubule. nephron’s convoluted tubule.

Therapeutic effects: diuretic (1-10), hypotensive (1-9). Pharmacological effects Side effects: hyponatremia, (1-10), hypochloremic alkalosis, hyperuricemia, hyperglycemia (1-9); acidosis (10).

Hypertension (1-4,6-9), heart failure, nephrotic syndrome, hepatic cirrhosis, nephropathy of Edemas as a result of chronic heart failure and Indications and pregnancy (1-9); eclampsia (1-6); non-diabetic polyuria, glaucoma (1-3,6); pulmonary, cardio-pulmonary failure, glaucoma, mild , acute and chronic renal failure (4,5,7); intoxication with barbiturates (4,5); interchangeability epileptic attacks (petit mal) (10). forced diuresis (4).

Diuretics are incompatible with adrenomimetics and sulfonamides. Treatment with thiazide, loop diuretics and carboanhydrase inhibitors should be carried out with a diet rich in potassium. Thiazide diuretics are contraindicated in severe renal failure. While taking thiazide diuretics the retention of and gout exacerbation, increase of glucose level in blood are possible. Doctor and pharmacist, Ethacrynic acid has a local irritating effect, that’s why its solutions shouldn’t be injected intramuscularly and subcutaneously. remember! Bumetanide, furosemide are not recommended to take together with agents accelerating nephrotoxic effects. Bumetanide has diuretic effect longer than furosemide does (up to 6 hours) and it is effective in smaller doses than furosemide. Furosemide is incompatible with other drugs in one syringe. Acetazolamide must not be taken more than five days (metabolic acidosis occurs). Before meals: 2,4,5,8. After meals: 1,7. During meals: 2,3.

DIURETIC DRUGS (CONTINUATION)

POTASSIUM-SPARING XANTHINE CLASSIFICATION OSMOTIC DIURETICS PLANT ORIGIN DIURETICS DIURETICS DERIVATIVES 1. (Veroshpirone, 4. (Mannit) 7. Lespenephril 12. Aminophylline Aldactone) 5. Urea (Carbamide) 8. Cowberry leaf (Euphylline) 2. (Pterophen) 6. Potassium acetate 9. Bearberry leaf 13. Drugs and their synonyms 3. 10. Orthosiphone leaf 11. Horse-tail herb

Decrease of membranes permeability (in distal parts of Increase of osmotic blood Increase of glomerular nephron’s convoluted tubules) for Increase of glomerular filtration pressure by decrease of water filtration (12-13); decrease Na+, Cl- ions, retention of K+ ions (preferably) and inhibition of Mechanism of action reabsorption along the whole of water reabsorption in due to block of reabsorption (7-11). renal canal (4-6). convoluted tubules (13). receptors (1), block of membrane Na-canals (2,3).

Pharmacological effects Diuretic (1-13), hypoazotemic (7), anti-inflammatory, antibacterial (8-11); spasmolytic (10,12,13).

Edema caused by hypertension, Cerebral, , Hypertension, edema caused heart failure; ascites in hepatic acute glaucoma attack (4,5); Renal edema, nephritis (7-10); chronic by heart and renal failure cirrhosis, nephrotic syndrome, Indications and intoxications with water-soluble renal failure, nonrenal (7); (only as a part of complex hypokalemia caused by treatment poisons, forced diuresis, acute inflammatory diseases of urinary tract (8- therapy), broncho- interchangeability with diuretics from other groups, renal failure (4); edema in blood 10); congestive heart failure (10,11). obstructive syndrome digitalis drugs (1-3). circulation insufficiency (6). (12,13). Hyperaldosteronism (1).

Potassium-sparing diuretics can cause hyperkalemia and hyponatremia. Potassium-sparing diuretics potentiate effect of thiazide diuretics. Doctor and pharmacist, Lespenephril isn’t prescribed simultaneously with psychotropic drugs. Aminophylline is forbidden to use simultaneously with drugs, containing , glucose solutions. remember! Horse-tail herb decoction is contraindicated in nephritis. Before meals: 10. After meals: 9.

CARDIOTONIC DRUGS

CARDIAC GLYCOSIDES NON- LILY OF THE VALLEY, CLASSIFICATION STROPHANTHUS SYNTHETIC DIGITALIS DRUGS ADONIS*, ERYSIMUM**, DRUGS CARDIOTONICS SCILLA MARITIMA*** DRUGS 1. (Lanicor, Dilacor) 8. Strophanthin K 10. Corglycon 14. (Inocor) 2. Digitoxin (Carditoxin) 9. Strophanthidine acetate 11. Adonisid 15. (Corotrop, 3. Cordigit 12. Cardiovalen Primacor) 4. Lanatoside (Celanide, Isolanide) 13. Meproscillarin (Clift) Drugs and their synonyms 5. Lantoside 6. Acetyldigoxin β (Novodigal) 7. Methyldigoxin (Bemecor)

Increase of Ca2+ ions concentration inside the myocardial cells → binding of Ca2+ ions to troponine → actomyosin complex formation → Mechanism of action myocardial contraction (1-15). A. Cardiotonic effect (1-15): 4) Positive batmotropic effect (increase of myocardial excitability). 1) Positive inotropic effect (strengthening and shortening of systole, B. Improvement of energy metabolism in myocardium (increase of ATP increase of cardiac output). content, increase of lactic acid utilization, decrease of oxygen consumption Pharmacological effects 2) Negative chronotropic effect (prolonging of diastole, decrease of by myocardium (1-15). cardiac rhythm). C. Diuretic effect (1-13). 3) Negative dromotropic effect (decrease of myocardial D. Sedative effect (10,11). conductivity). E. Anticonvulsive effect (10,11). High absorption from gastro-intestinal tract, high ability to bind to plasma proteins, slow onset and long duration of action, accumulation (1-7). Very low absorption from gastro-intestinal tract, low ability to bind to plasma proteins, rapid onset and short duration of action (8-10). Indications and Chronic heart failure (1-7,11-13), angio-vegetative neurosis (11,12), acute heart failure (3,4,8,10), short-term therapy of acute heart failure after the interchangeability surgeries on heart (14,15). Cardiac glycosides are incompatible with α- and β-adrenoblockers, barbiturates, local anesthetics, aminazine, reserpine; calcium-, iron-containing drugs; sympatholytics, α- and β-adrenomimetics, antiarrhythmic agents, furosemide, spironolactone, calcium antagonists, amphotericin B. As a result of accumulation cardiac glycosides cause a severe intoxication; the treatment should be carried out only under the strict doctor’s control. When combining cardiac glycosides with diuretics-saluretics, glucocorticosteroids there is a possibility of their toxic effect increase, as a result of Doctor and pharmacist, hypokalemia, that requires the simultaneous intake of potassium-containing drugs. Digitoxin is incompatible with adrenaline h/chl, isadrin, mesatone, reserpine. remember! In case of taking digitoxin together with butamide the risk of glycoside intoxication increases. Strophanthin is incompatible with aminazine and muscle relaxants. Amrinone and milrinone solutions mustn’t be combined with the solutions containing dextrose, furosemide, bumetanide, sodium hydrocarbonate in one syringe. After meals:6.

ANTIARRHYTHMIC DRUGS

DRUGS FOR DRUGS FOR TREATMENT TACHYARRHYTHMIAS TREATMENT BRADYARRHYTHMIAS CLASSIFICATION MEMBRANE STABILIZERS -ADRENOBLOCKERS AGENTS CALCIUM M-CHOLINO- -ADRENOMI- 1. Quinidine 9. Propranolol (Anaprilin) PROLONGING ANTAGONISTS. BLOCKERS METICS 2. (Novocainamide) 10. Metoprolol (Corvitol) REPOLARIZA- POTASSIUM DRUGS* 17. Atropine 18. Isoprenaline 3. Praymaline (Neo-hyluritmal) 11. Sotalol (Hylucor) TION 15. Verapamil h/chl. sulfate (Isadrin) 4. Moracisine h/chl. (Etmosine) 12. Acebutolol (Sectral) 14. (Isoptine) (Atromed) 19. Dobutamine Drugs and their 5. (Palpitine) 13. Nadolol (Corgard) (Cordarone) 16. Potassium and (Dobutrex) synonyms 6. Lidocaine (Xycaine) magnesium asparaginate* 7. Phenitoin (Diphenin) (Asparkam) 8. Propaphenone Slow-down of cardiomyocytes Stimulation of Decrease of Block of Na+ ions transport depolarization due to Decrease of  -adrenoceptors membrane 1 Inhibition of Na+, K+, Ca2+, Cl- during depolarization in inhibition of Ca2+ ions parasympathe- in heart, increase permeability for ions transport through sinoatrial node; decrease of transport through the tic nerves of cAMP and Mechanism of action K+ ions → membranes of cardiomyocytes. sympathetic system “slow” Ca-canals (15), influence on calcium content repolarization influence on heart. increase of K+ ions heart. in cardiomyo- prolonging. content in cardiomyocytes cytes. (16). Pharmacological effect HEART RHYTHM NORMALIZATION (1-19). Indications and Atrial tachycardia (5,10,12-15), ventricular tachycardia (1-4,6,8,9,11,14), atrial extrasystole (4,5,9,10,12-15), ventricular extrasystole (1-6,8,10-14,16), supraventricular paroxysmal tachycardia (1,3-5,10,11,14-16), cardiac fibrillation (1-4,9,16), cardiac glycosides intoxication (3,4,7,16), surgeries on interchangeability heart, large vessels and lungs (2), hypertension (9-15), angina pectoris (9-16); bradyarrhythmias, atrioventricular blockade (17-19). Antiarrhythmic drugs are incompatible with -adrenomimetics, oral hypoglycemic drugs, psychomotor stimulants, anticholinesterase agents, sedatives, cardiac glycosides, cholinomimetics, isoniaside and its derivatives, levomycetin, coumarin, acetylsalicylic acid, teturam, neuroleptics and tranquilizers. Quinidine is very toxic and can cause heart failure. Quinidine and novocainamide are not prescribed in case of cardiac glycosides intoxication. Doctor and pharmacist, Novocainamide shouldn’t be used with sulfonamides (competitive antagonism). Novocainamide intravenous injection can cause collapse. Etmosine is incompatible with MAO inhibitors. remember! Potassium salts are incompatible with cardiac glycosides. 2% lidocaine solution is dissolved in isotonic solution of . Diphenin is incompatible with gentamycin, digitoxin, proserine, isadrin, sulfonamides. Dobutamine solutions mustn’t be mixed with alkaline solutions in one syringe. Before meals: 1,14,16. After meals: 7,15.

ANTIANGINAL DRUGS

CORONARODILATORS, CALCIUM  -ADRENO- CLASSIFICATION 1 MYOCARDIAL METABOLISM ANTAGONISTS BLOCKERS ACTIVATORS*. 1. Nitroglycerin (Nit-Ret) 6. (Fenigidine) 12. Atenolol (Tenormin) 16. Carbocromen h/chl. (Intencordin) 2. trinitrate (Sustac) 7. (Norvask) 13.Metoprolol (Betalok) 17. Trimetasidine* (Preductal) 3. (Isodinit) 8. Dilthiazem (Diazem) 14. Talinolol (Cordanum) 4. (Isosorb) 9. Verapamil h/chl. (Lekoptin) 15. Acebutolol (Sectral) Drugs and their synonyms 5. Pentaerythrityl tetranitrate 10. Hallopamil (Procorum) (Dilkoran) 11. (Barisine)

Inhibition of phosphodiesterase → Block of Ca2+ ions flow inside Release of nitrogen oxide (II) → Selective block of  - increase of cAMP conversion into 5-AMP the cardiomyocytes and smooth 1 restoration of endothelial relaxing adrenoceptors in (16). Mechanism of action muscles cells of the coronary factor level. myocardium. Improvement of transport through vessels. membranes of cardiomyocytes (17).

Antianginal (1-17), coronarodilating (1-11,16) effects; decrease of oxygen consumption by myocardium (1-15), increase of myocardium supply Pharmacological effects with oxygen (1-11, 16), preferable decrease of venous pressure (1-5), improvement of coronary blood flow (16), normalization of metabolism in heart (17); antiarrhythmic, antihypertensive effects (6-15).

All kinds of angina pectoris Prophylaxis and treatment of angina (treatment and prophylaxis) (1-5). Combined therapy of Indications and Angina pectoris, resistant to pectoris attacks (16). Medical rehabilitation after ischemic heart disease (12- nitrovasodilators (6-11). Prolonged treatment of coronary interchangeability myocardial infarction (2-4). 15). insufficiency (17). Myocardial infarction, pulmonary edema (1,3). Nitrates are incompatible with vasodilators, calcium antagonists, tricyclic antidepressants. Doctor and pharmacist, Verapamil, hallopamil are not recommended to combine with -adrenoblockers, antiarrhythmic drugs, inhalation anesthetics, cardiac glycosides. Atenolol has longer effect than other -adrenoblockers. remember! Talinolol doesn’t cause orthostatic hypotension. After meals: 10.

DRUGS AFFECTING CEREBRAL CIRCULATION

DIHYDRATED DRUGS CONTAINING CALCIUM DERIVATIVES OF ERGOT COMBINED CLASSIFICATION OTHER DRUGS ANTAGONISTS ALKALOIDS, EXTRACT*, PERIWINKLE DRUGS -ADRENOBLOCKERS* PLANT ALKALOIDS 1. (Stugeron) 4. Dihydroergotamine (Ergotam) 7. Ginkgo biloba extract* 10. Instenone 12. Pentoxiphylline 2. (Nimotop) 5. Dihydroergotoxin (Redergin) (Tanakan) 11. Vasobral (Trental) Drugs and their 3. (Sibelium) 6. Nicergolin* (Sermion) 8. Vinpocetin (Cavintone) 13. Xanthinol nicotinate 9. Vincamine (Oxibral) (Complamine) synonyms 14. Pyracetam (Nootropil) Stimulation of Improvement of blood cerebral rheologic properties, Block of Ca2+ ions flow Block of  -adrenoceptors in Increase of brain supply with 1 metabolism, activation of inside the cells of smooth vessels, regulation of intracellular oxygen and glucose, activation of Mechanism of action activation of fibrinolysis (12-13), muscles in vessels. cAMP content. cellular metabolism. reticular increase of GABA level formation. (14).

Improvement of cerebral circulation (1-14), dilation of cerebral vessels (1-6,8,12-14), regulation of the arterial and venous tone (4-9,12-13); Pharmacological effects antihypoxic, anti-ischemic (1-3,12-14), antiaggregant (1-3,7-9,12,13) effects.

Indications and Prophylaxis and treatment of acute and chronic cerebral circulation disorders, consequences of the craniocerebral trauma (1-3,5-14); migraine (4- interchangeability 6,9,11,13), peripheral angiopathy (1-5,9-13), angiospasm of the eye retina (7), cerebral vessels thrombosis (9,12,13), labyrinth disorders (1-3,7-11).

Nimodipine mustn’t be used with aminoglycosides, cephalosporins, furosemide simultaneously. Complamine shouldn’t be taken together with hypotensive drugs. Stugeron, vinpocetin, instenone, pentoxiphylline have antiaggregant effect, that’s why they mustn’t be combined with anticoagulants and Doctor and pharmacist, antiaggregants. Stugeron can cause mild sedative effect. remember! Instenone has to be injected only intravenously (slowly). Before meals: 5,6. After meals:1. During meals: 7,11. I. DRUGS AFFECTING NERVOUS SYSTEM II.DRUGS NOT AFFECTING NERVOUS SYSTEM

CLASSIFICATION OF 1. 2-adrenomimetics 1. Vasodilators (peripheral vasodilators, ACE inhibitors, angiotensin receptors THE antagonists, calcium antagonists, myotropic spasmolytics, etc.) 2. Sympatholytics 2. Diuretics ANTIHYPERTENSIVE DRUGS 3. Adrenoblockers 3. Other drugs 4. Ganglionic blockers 5. Imidazoline receptors agonists III. COMBINED ANTIHYPERTENSIVE DRUGS 6. CNS depressants

COMBINED ANTIHYPERTENSIVE DRUGS

DRUGS CONTAINING -ADRENO- DRUGS CONTAINING ACE CLASSIFICATION DRUGS CONTAINING RESERPINE BLOCKER AND DIURETIC INHIBITOR AND DIURETIC 1. Adelfan-ezidrex 2. Viskaldix 3. Caposide Drugs and their synonyms 4. Captopres

Pharmacological effects Antihypertensive (hypotensive) (1-4), diuretic (2-4), potassium-sparing (1) effects.

Indications and Hypertension (1-4). interchangeability

Doctor and pharmacist, Adelfan-ezidrex is incompatible with MAO inhibitors, ACE inhibitors. remember! Caposide shouldn’t be used together with glucocorticosteroids, cytostatics, potassium-sparing diuretics, lithium drugs, , heparin.

ANTIHYPERTENSIVE DRUGS

CLASSIFICATION CENTRAL-ACTING α2–ADRENOMIMETICS SYMPATHOLYTICS -ADRENOBLOCKERS α1-ADRENOBLOCKERS 1. Clonidine h/chl. (Clofelin, Hemitone, 4. Reserpine (Serpasil) 6. (Trimepranol) 10. (Minipres, Catapresan) 5. Raunatin 7. Sotalol (Darob, Hylucor) Adversuten) 2. Methyldopa (Aldomet, Dopegit) 8. Acebutolol (Sectral) 11. (Cardura) Drugs and their synonyms 3. h/chl. (Estulik) 9. Metoprolol (Corvitol) 12. (Cornam)

Decrease of Stimulation of  –adrenoceptors in vasomotor Block of β -adrenoceptors in 2 noradrenaline, adrenaline 1 center, decrease of noradrenaline output in the myocardium, decrease of cardiac Block of α -adrenoceptors and dopamine content in 1 Mechanism of action synaptic cleft, elimination of the central output and oxygen consumption in peripheral vessels. the presynaptic sympathetic pressor influence on the arteries. by myocardium. membrane. Dilatation of arteries, Decrease of TPVR, BP; Decrease of BP, TPVR (1-3); cardiac output (1,3), Antihypertensive, antianginal, decrease of TPVR, BP, sedative effect (4-5); Pharmacological effects intraocular pressure (1); sedative effect (1). antiarrhythmic effects. prostate smooth muscles antiarrhythmic effect (5). tone.

Monotherapy of hypertension in young patients, combined Indications and Essential and renal hypertension (1-3), Hypertension at the early Hypertension, adenoma of therapy (with α-adrenoblockers) hypertensive crisis (1,2), glaucoma (1). stages (4,5). prostate (10-12). interchangeability of severe hypertension in elderly patients (6-9).

Antihypertensive drugs are incompatible with adrenal corticoids. Clonidine h/chl., methyldopa, guanfacine h/chl. are not recommended to use together with antiarrhythmic drugs, calcium antagonists, vasodilators, antidepressants, phenothiazine derivatives, narcotic analgesics, noradrenaline, reserpine, cardiac glycosides, oral hypoglycemic drugs, antacids. Doctor and pharmacist, Reserpine and raunatin mustn’t be taken together with analeptics, adreno- and cholinomimetics. remember! -adrenoblockers are incompatible with tricyclic antidepressants. -adrenoblockers are incompatible with narcotic analgesics, anticholinesterase agents, tricyclic antidepressants, ergot drugs. Before meals: 7. After meals: 4,9.

ANTIHYPERTENSIVE DRUGS (CONTINUATION)

PERIPHERAL ACE INHIBITORS, ANGIOTENSIN CALCIUM ANTAGONISTS, IMIDAZOLIN RECEPTORS CLASSIFICATION VASODILATORS RECEPTORS* ANTAGONISTS AGONISTS*, SPASMOLYTICS** 1. Hydralazine h/chl. 6. Enalapril 11. Perindopril 15. Hallopamil (Procorum) 22. Moxonidine* (Cint) (Apressin) (Ednit) (Prestarium) 16. Amlodipine (Norvask) 23. Papaverin h/chl.** 2. (Hyperstat) 7. Quinapril 12.Lisinopril 17. (Lacipil) 24. Platiphylline hydrotartrate + Drugs and their 3. (Accupro) (Lisopres) 18. (Lomir) papaverin h/chl.** synonyms 4. Sodium nitroprusside 8. Ramipril 13.Potassium 19. (Posikor) 25. Bendasol** (Dibasol) (Nanipruss) 9. Captopril losartan* (Cosaar) 20. Verapamil h/chl. 26. Papasol** (papaverin h/chl. + 5. (Corvatone) 10. Moexipril 14.Valsartan* 21. Dilthiazem dibasol) (Moex) Block of Ca2+ ions transport inside the smooth muscles cells of vessels Selective relaxation of smooth (15-21). Imidazolin receptors stimulation, inhibition of vasomotor center Inhibition of ACE (6-12); block of muscles of the peripheral activity, decrease of central sympathetic pressor influence on vessels Mechanism of action angiotensin receptors (13,14). arteries (1-3) and veins (4,5). (22). Smooth muscles relaxation due to phosphodiesterase inhibition and cAMP accumulation (23-26). Block of M-cholinoceptors (24).

Decrease of BP (1-14); dilatation of arteries and veins; decrease of Decrease of BP (15-26), antianginal, antiarrhythmic (15-21), Pharmacological effects TPVR, cardiac post-load (1-3); decrease of venous return of blood to the spasmolytic (23-26), sedative (22-24), moderate immuno-stimulative heart, cardiac pre-load (4,5). (25) effects. Symptomatic hypertension, Hypertension, hypertensive crisis, hypertension combined with angina hypertension resistant to Extremely severe hypertension, chronic Indications and pectoris (15-21, 23-26); hypertension combined with renal failure, therapy with - renal failure (6-14); hypertensive crisis ischemic stroke, prophylaxis and treatment of tachyarrhythmia (15-21); interchangeability adrenoblockers, sympatho- (6-12), acute heart failure (6-8,10,11). essential arterial hypertension (22). lytics, diuretics (1-5). Vasodilators are incompatible with local anesthetics. Enalapril, moexipril, perindopril shouldn’t be prescribed together with potassium-sparing diuretics. Quinapril mustn’t be used together with hypnotics, narcotic analgesics, tetracyclines. Ramipril is incompatible with narcotic analgesics, local anesthetics. Doctor and pharmacist, Verapamil, hallopamil are not recommended to combine with -adrenoblockers, antiarrhythmic drugs, inhalation anesthetics, cardiac glycosides. Mibefradil mustn’t be used with , , asthemisol. remember! Papaverin is incompatible with anticoagulants, dibasol, , acetylsalicylic acid, prednisolone, sodium bromide, sodium hydrocarbonate. Dibasol is incompatible with adrenaline h/chl., atropine sulfate, benzohexonium, magnesium sulfate, euphylline, papaverin, vitamin C. ACE inhibitors are contraindicated in pregnancy because of the risk of the fetus abnormalities development. After meals: 1,15,19. During meals: 15,19.

DRUGS FOR ATHEROSCLEROSIS TREATMENT

DRUGS AFFECTING LIPID METABOLISM CLASSIFICATION ANTIOXIDANTS ANGIOPROTECTORS (HYPOLIPIDEMIC DRUGS) 1. 5.Cholestyramine 8.Hemfibrosil 11.Probucol DIRECT-ACTING INDIRECT- 18.Pyrycarbate 19.Heparin (Mevacor) (Cholestan) 9.Cyprofibrate (Lipomal) 12.Tocoferol acetate ACTING (Parmidine) 20.Ticlopidin 2.Simvasta- 6.Cholestipol (Lipanor) (vitamin E) 15.Methionin (Ticlid) Drugs and their tin (Zocor) (Cholestid) 10. Phenofibrate 13.Rutin (vitamin P) 16.Lipoic acid synonyms 3.Fluvastatin 7.Huaric resin (Lipantil) 14.Ascorbic acid 17. Glutaminic (Leskol) (Guarem) (vitamin C) acid 4.Pravastatin (Lipostat) Influence on Inhibition of Inhibition of the the synthesis Inhibition of Activation of the Decrease of cholesterol and bile and redistri- Inhibition of the non-enzymatic lipid coagulation lipoprotein lipase Mechanism of action synthesis in acids absorption in bution of peroxidation of the cell membranes. factors in liver. activity. liver. the intestine. lipids in the activity. body. Improvement Pharmacological Hypolipidemic effect; decrease of the cholesterol, triglycerols, low Prevention of the elastic vascular fibers of metabolic , density lipoproteins concentrations; increase of high density destruction, lipid infiltration processes processes in anti-aggregant effects lipoproteins concentrations in blood. and fibrosis. the vascular effects. walls. Indications and Atherosclerosis (1-20), hyperlipidemia (1-11), coronary insufficiency (18-20), diabetes mellitus (7,15). interchangeability Lovastatin, lipanor, pravastatin are not recommended to combine with , cyclosporin, erythromycin, . Lovastatin mustn’t be combined with nicotinic acid. Cholestyramine shouldn’t be taken together with other drugs. The level of fat-soluble vitamins in the body can decrease in case of prolonged cholestyramine intake. Doctor and pharmacist, Cholestipol mustn’t be used together with digitalis drugs. Hemfibrosil mustn’t be combined with lovastatin because of the possibility of severe myopathy appearance. remember! Fibrates prevent thrombus formation due to the activation of fibrinolysis. Fibrates promote the development of cholelithiasis. Ticlopidin isn’t recommended to use together with high doses of heparin. Before meals: 15,17. After meals: 16. During meals: 1,2,5-9,11,20. CLASSIFICATION OF ANTIBIOTICS

VII. MACROLIDES AND AZALIDES . -LACTAM ANTIBIOTICS 2. Cephalosporins (-II generations) 1. Penicillins (-V generations) VIII. TETRACYCLINES 1.1 Natural penicillins 3. Carbapenems and Monobactams IX. LINCOSAMIDES 1.2 Antistaphylococcal penicillins II. GLYCOPEPTIDES X. CHLORAMPHENICOLS 1.3 Penicillins with the extended spectrum of III. POLYMYXINS XI. FUSIDINES action IV. GRAMICIDIN XII. AMINOGLYCOSIDES 1.4 Antipseudomonal penicillins V. (-II generations) 1.5 Penicillins combined with -lactamase VI. ANTIFUNGAL ANTIBIOTICS (POLYENES) XIII. RIFAMPICINS inhibitors XIV. PHOSPHOMYCINS

CLASSIFICATION OF ANTIBIOTICS ACCORDING TO THE MECHANISM OF ACTION

BACTERICIDAL ANTIBIOTICS BACTERIOSTATIC ANTIBIOTICS

Inhibitors of cytoplasmatic membrane Inhibitors of synthesis of microbial cell wall Inhibitors of protein synthesis Inhibitors of protein and nucleic acids synthesis functions

-Lactams Polymyxins Azalides Macrolides*

Gramicidin Glycopeptides Aminoglycosides Lincosamides Cycloserine

Tetracyclines Phosphomycins Antifungal antibiotics (polyenes) Rifampicins (ansomacrolides) Fusidines Chloramphenicols**

*-Macrolides have a bactericidal effect on diphtheria bacillus, causative agent of pertussis. **- Chloramphenicols have a bactericidal effect on influenza bacillus, meningococcus, pneumococcus.

PENICILLINS Peculiarities of the group: 1. Potent bactericidal effect (streptococcus, meningococcus, gonococcus, diphtheria bacillus, anthrax bacillus, spirochetes, others). 2. Low toxicity. 3. Good absorption. 4. Wide interval of therapeutic action. 5. Cheapness and accessibility. 6.Polyvalent allergy between penicillins and partly cephalosporins.

CLASSIFICATION NATURAL PENICILLINS SEMISYNTHETIC PENICILLINS SHORT-ACTING DEPO-DRUGS ANTISTAPHYLO- EXTENDED ANTIPSEUDOMONAL COMBINED AGENTS ONES COCCAL ONES SPECTRUM ONES 3. Benzatine ONES 17. Ampicillin + Sulbactam 1. benzylpenicil- 5. Oxacillin 12. Carbenicillin (Unazine) sodium and lin (Bicillin-1, (Prostaphlin) 8. Ampicillin 13. Ticarcillin 18. Amoxicillin + Clavulanic potassium salts Extencillin) 6. Cloxacillin trihydrate 14. Azlocillin acid (Augmentine, Amoxiclav) Drugs and their (Penicillin G) 4. Bicillin-5 (Tepogen) (Pentrexil) 15. Piperacillin (Isipen) 19. Ticarcillin + Clavulanic acid synonyms 2. Phenoxymethyl 7. Fluocloxacillin 9. Amoxicillin 16. Mezlocillin (Baypen) (Timentine) penicillin (Flemoxin) 20. Amoxicillin + Metronidazole (Penicillin V, 10. Penamecillin (Helicocin) Ospen) (Maripen) 21. Ampicillin + Oxacillin 11. Bacampicillin (Ampiox) (Penglobe) 22. Amoxicillin + Cloxacillin (Vampilox) ◊ - resistance to β-lactamases  - acid-resistance Mechanism of action Inhibition of synthesis of the bacterial cell wall. G+ and G- cocci: streptococci (1-11,16,21,22), staphylococci (5-11,17-19,21,22), meningococcus (1-10,17-19,21,22), gonococcus (1-11, 17- 19,21,22); listerias (1-4,8,9,16,21,22), diphtheria bacillus (1,16,21), anthrax bacillus (1,21), spirochetes (treponema pallidum, leptospira, borrelia) (1- Spectrum of action 4,21), clostridia (1,14-19,21), colon bacillus (8-11,14-19,21,22), blue pus bacillus (12-16), helicobacter pylori (8,9,20), influenza bacillus (8,9,11,16,17,19,22). Indications and Pneumonia, rheumatism, erysipelas (1-10,14-19,21,22); angina, scarlatina, endocarditis, purulent infections (1-3,5-9,17-19,21,22); syphilis (1-3,21), pseudomonal infection (12-16), enteric infections (8-19,22), gangrene, diphtheria, gonorrhea, anthrax, bacterial meningitis (1,21); peptic ulcer interchangeability (8,9,20), wound infections (1-9,12-14,21,22), purulent skin and soft tissues infections (1-5,8,9,21,22), urologic infections (8,17-20). Side effects Allergic reactions, dysbacteriosis (1-22); dyspepsia (5,8), neurotoxicity (12), bleeding sickness (12,13).

Penicillins are incompatible with macrolides, adrenaline, α-globulin, glucose, potassium iodide, vitamins C, P, K, B1, B12; anticoagulants, streptomycin, levomycetin. Solutions of benzylpenicillin sodium and potassium salts, timentine mustn’t be mixed with other drugs in one syringe. Doctor and pharmacist, Piperacilllin is incompatible with sodium hydrocarbonate and aminoglycosides. remember! One should avoid to use simultaneously bacteriostatic and bactericidal antibiotics. Amoxiclav, timentine inactivate aminoglycosides. Carbenicillin mustn’t be mixed with aminoglycosides in one syringe (inactivation). Before meals:7. CEPHALOSPORINS

CLASSIFICATION Ist GENERATION IInd GENERATION IIIrd GENERATION IVth GENERATION Bactericidal effect mostly Broad spectrum of action and high Effectiveness against G- bacilli and partly High effectiveness against against G+ cocci. resistance to -lactamases of the G- against blue pus bacillus. Drugs are much G- bacteria, including - Peculiarities of the group bacteria. Drugs are not effective against more effective against Enterobacteriaceae lactamase-producing ones. enterococci and blue pus bacillus. than Ist and IInd generations of cephalosporins. 1. Cephazolin (Cephzole, 7. Cephuroxime (Ketocef, Zinnat) 14. Cephotaxime (Claforan) 25. Cephepime (Maxipime) Totacef) 8. Cephaclor 15. Cephtazidime (Fortum) 26. Cephpirome (Keyten) 16. Cephoperazone 2. Cephapirin (Cephatrexil) 9. Cephotetan 10. Cephamandole (Mandole) 17. Cephtriaxone (Lendacine) 3. Cephadroxil (Duracef) 11. Cephoxitin (Mefoxin) 18. Cephodizime (Modivid) 4. Cephalexin Drugs and their synonyms 12. Cephmetazole (Cephmetazone) 19. Cephprozil (Cephzil) 5. Cephradine (Cephradal) 13. Cephonicid 20. Cephpyramide (Tamicin) 6. (Cephorin)  - acid-resistance 21. Cephpodoxime (Orelox) 22. Cephtibuten (Cedex) 23. Cephixime 24. Cephtizoxime (Epoceline) Mechanism of action Inhibition of synthesis of the bacterial cell wall. G+ and G- cocci, bacilli; G+ and G- cocci; high effectiveness Spectrum of action is broader, than the Ist and IInd generations’ spectra are; high antistaphylococcal against escherichias, klebsiellas, proteus, Spectrum of action effectiveness against blue pus bacillus, anaerobes. activity. salmonella. Infections of urinary and respiratory tracts, skin, Pneumonias, pelvic and intra-abdominal Indications and Pelvic, septic severe infections, anaerobic infections (gas gangrene), bones and joints; infections, meningitis, sepsis, gonorrhea, pseudomonal infections. interchangeability prophylaxis of postoperative postoperative septic complications. complications. Allergic reactions (including polyvalent ones with penicillins), dyspepsia, phlebitis, hematologic disorders (leukopenia, hypoprothrombinemia, Side effects eosinophilia), dysbacteriosis. The Ist and IInd generations of cephalosporins are not active against blue pus bacillus. Cephazolin, cephuroxime, cephtriaxone, cephpyramide, cephepime mustn’t be used simultaneously with loop diuretics, . Doctor and pharmacist, Cephotaxime, cephtriaxone, cephalothin, cephaloridine solutions are incompatible with other antibiotics’ solutions in one syringe. Cephtazidime, cephodizime, cephepime are not combined with aminoglycosides, amphotericin B, cyclosporine, cysplatin, vancomycin, polymyxin B, remember! furosemide. Cephalosporins of the II-IV generations have postantibiotic effect. Before meals: 4. After meals: 9.

OTHER -LACTAM ANTIBIOTICS

CLASSIFICATION CARBAPENEMS MONOBACTAMS

Superbroad spectrum of action and absolute resistance to Reserve antibiotics for treatment severe intrahospital infections. Peculiarities of the group -lactamases.

Drugs and their synonyms 1. -cilastatin (Conet, Tienam) 3. Aztreonam (Azactam) 2*. Meropenem (Meronem) - resistance to -lactamases *-resistance to renal dehydropeptidase Mechanism of action Inhibition of synthesis of the microbial cell wall.

Streptococci (including enterococci); staphylococci (including Colon bacillus, salmonellas, shigellas, enterobacteria, clostridia, penicillinase-forming), gonococci, meningococci, colon bacillus, proteus, blue pus bacillus, serracia, influenza bacillus, gonococcus, Spectrum of action salmonellas, shigellas, klebsiella, proteus, citrobacteria, blue pus meningococcus. bacillus, spore-forming and not spore-forming anaerobes.

Severe infections caused by G- flora (including ones, resistant to III Indications and Super severe infections, caused by polyresistant microorganisms; generation of cephalosporins, II-III generations of aminoglycosides, mixed infections (1-2). interchangeability antipseudomonal penicillins) (3).

Allergic reactions, phlebitis (in case of intravenous injection); pain, tissues edema (in case of intramuscular injection); dyspepsia, diarrhea, Side effects pseudomembranous colitis, neurotoxicity (1); hepatotoxicity (2).

Carbapenems are super reserve antibiotics. Monobactams solutions are incompatible with other antibiotics solutions and drugs, containing probenecide in one syringe. Doctor and pharmacist, Combination of monobactams with furosemide and probenecide increases monobactams’ (aztreonam) concentration in blood and risk of side effects appearance. remember! Carbapenems and monobactams have postantibiotic effect, decrease the endotoxicosis. Imipenem and other -lactam antibiotics are antagonists. It is undesirable to combine meropenem with nephrotoxic antibiotics.

TETRACYCLINES AND MACROLIDES

CLASSIFICATION TETRACYCLINES MACROLIDES AND AZALIDES* Bacteriostatic effect. Broad spectrum of Bacteriostatic (in high concentrations – bactericidal) effect. Broad spectrum of action. Peculiarities of the group action (G+and G- microorganisms). Low is higher, than tetracyclines’one is (good penetration in tissues and cells). High toxicity. Good absorption. effectiveness against intracellular microorganisms. NATURAL ONES SEMISYNTHETIC Ist GENERATION IInd AND IIIrd GENERATION COMBINATIONS OF TETRACYCLINES ONES AND MACROLIDES 1. Tetracycline 6. Erythromycin 8. Jozamycin 15. Oletetrin 3. 7. Oleandomycin 2. Oxytetracycline 9. Roxythromycin (Rulid) 16. Erycycline Drugs and their synonyms (Rondomycin) 10. Spyramycin (Rovamycin) 4. 11. Midecamycin (Macropen) (Minocin) 12. 5. Doxycycline 13. Azithromycin* (Sumamed)  - acid-resistance (Unidox, 14. Dirithromycin Vibramycin) Mechanism of action Inhibition of protein synthesis in the microbial cell at the level of ribosomes.

Streptococci, staphylococci, gonococci, meningococci, campilobacteria, clostridia, spirochetes, chlamydia, mycoplasma (1-16); listerias, diphtheria Spectrum of action bacillus (1-15); comma bacillus, tularemia causative agent (1-14); legionella (6-14); pertussis causative agent (6-10); brucella (1-6,14); actinomycete, salmonellas, shigellas (1-5); ureaplasma (8-15); malarial plasmodium (1,5).

Indications and Angina, sinusitis, bronchitis, pneumonias (mycoplasmic, chlamydial) (1-16); staphylococcal infections, diphtheria, pertussis, scarlatina (6-12); intestinal infections, plague, tularemia, syphilis, malaria (1,5); campilobacteriosis (1,5,12), urethritis, gonorrhea (15); ricketsiosis, toxoplasmosis interchangeability (11); acne (1-6). Allergic reactions, dyspepsia, multidrug resistance (1-16); protein metabolism disorders, teeth and bones formation disorders, nephrotoxicity, Side effects syndrome of brain pseudotumor (increase of ) (1-5); esophagus erosions (1-3); dysbacteriosis, superinfection, photodermatosis, hepatoxicity (1-5,15,16). Tetracyclines aren’t used simultaneously with antacids, iron-containing drugs, cyclosporine, vitamin C, anticoagulants, calcium-containing drugs, streptomycin, penicillin; drugs, containing dihydrated ergot alkaloids. Barbiturates, diphenin, carbamazepine increase tetracyclines’ metabolism. There is a synergism in case of combination of tetracyclines with aminoglycosides, lincosamides, macrolides. There is antagonism in case of Doctor and pharmacist, combination of macrolides and azalides with penicillins, cephalosporins, lincosamides; synergism – with tetracyclines, streptomycin, sulfonamides. Macrolides of the IInd and IIIrd generations accumulate in neutrophils and macrophages and are transported with them to inflammatory focus. remember! Erythromycin is incompatible with penicillin, tetracycline, lovastatin, aminophylline, . Roxythromycin mustn’t be used simultaneously with ergot drugs, bromocriptine. Clarithromycin increases astemizole’s cardiotoxic effect. Before meals: 6,9,11. After meals: 1,3,5,7.

AMINOGLYCOSIDES AND GLYCOPEPTIDES

CLASSIFICATION AMINOGLYCOSIDES GLYCOPEPTIDES Bactericidal antibiotics. Effectiveness against many G- and several G+ aerobic bacteria. Effectiveness in case of severe generalized infections. Peculiarities of the group Postantibiotic effect. Bactericidal antibiotics. ST ND RD Drugs and their synonyms I GENERATION II GENERATION III GENERATION 1. Streptomycin 5. Gentamycin 6. Amikacin 10. Izepamycin 13. Vancomycin (Edicine) 2. (Garamycin) 7. Tobramycin 11. Paromycin 14. Teucoplanin (Targocide) 3. Canamycin 8. Netilmycin 12. Phramicetin  - acid-resistance 4. Monomycin 9. Sizomycin Inhibition (irreversible) of protein synthesis in the microbial cell at the level of Mechanism of action ribosomes. Binding to cytoplasmic microbial membranes → disruption of their Inhibition of synthesis of bacterial cell wall. permeability → loss of potassium ions, aminoacids, nucleotides by microbial cell. Staphylococci (including penicillin- and Escherichia, klebsiella (1-11); proteus, shigella, salmonella (3-11); blue pus bacillus methycillinresistant ones), streptococci, enterococci, (5-9), brucella (1,5), mycobacterium tuberculosis (1,2,10), mycobacterium leprae (1), Spectrum of action corynebacteria, clostridia, listeria (13,14); micrococci staphylococcus (1-10,12), plague causative agent (1,2). (14), actinomycete (13). Phlebitis (13,14), “red man” syndrome (in case of rapid Neurotoxicity, ototoxicity, nephrotoxicity; muscle relaxant effect, erythematous rash, injection), rash, skin itch, nausea (13,14); hypotension, Side effects fever, dyspepsia. fever (13); diarrhea, bronchospasm, dizziness, headache (14). Tuberculosis (1), intestinal infections, pneumonia, sepsis (2-11); preoperative intestinal Severe generalized infections, caused by multidrug resistant Indications and sterilization (2,3), pseudomonal infections (5-11), urinary tract infections (4-11); plague, staphylococci, streptococci; pseudomembranous colitis, leprosy, leishmaniasis (1-2); infected burns (1-6), infectious-inflammatory diseases in interchangeability prophylaxis and treatment of wound infections (13-14). rhinopharyngeal region (12). Aminoglycosides are incompatible with each other and other oto- and nephrotoxic drugs. Streptomycin is incompatible with glucose, vitamin B1, sodium thiosulfate, carbenicillin, erythromycin, muscle relaxants. Neomycin is incompatible with penicillin. Canamycin is incompatible with loop diuretics, ethacrynic acid, muscle relaxants, anesthetics; it potentiates antibacterial effect of penicillins, cephalosporins, fluoroquinolones. Doctor and pharmacist, Gentamycin is incompatible with vitamin B2, phenobarbital, prednisolone, diphenine, dimedrol. Amikacin mustn’t be used simultaneously with loop diuretics, carbenicillin, cephalosporins. remember! Tobramycin is incompatible with furosemide, ethacrynic acid. Netilmycin is incompatible with muscle relaxants and polymyxines. Glycopeptides mustn’t be combined with aminoglycosides, polymyxines, ethacrynic acid, avoiding increase of neuro- and nephrotoxicity. It is impossible to mix streptomycin with penicillins and cephalosporins in one syringe. In case of long-term contact with streptomycin, one should put on gloves (dermatosis may occur). Streptomycin perverts the effects of reflex-acting analeptics. Tobramycin shouldn’t be mixed with other drugs in one syringe or medicine dropper.

FLUOROQUINOLONES

Peculiarities of the group: Effectiveness against the majority of G- and several G+ bacteria (including penicillinase-producing aerobes). Good tolerance. Bactericidal drugs. Decrease of aggressive properties of bacteria, their virulent properties; inhibition of exotoxins, exoenzymes production; increase of microorganisms’sensitivity to phagocytosis.

CLASSIFICATION Ist GENERATION IInd GENERATION IIIrd GENERATION 1. (Cifran) 7. Lomefloxacin (Maxaquin) 9. Fleroxacin (Quinodis) 2. (Tarivid) 8. Sparfloxacin 10. Trovafloxacin Drugs and their synonyms 3. Pefloxacin (Abactal) 11. Grepafloxacin (Raxar) 4. Norfloxacin (Nomycin) 4a. NFlox-T (norfloxacin+thinidazole)  - acid-resistance 5. Enoxacin (Enoxor) 6. Rufloxacin

Mechanism of action Inhibition of bacterial DNA-gyrase (topoisomerase) → dysruption of DNA, RNA, protein biosynthesis in bacterial cell.

Staphylococci, gonococci, legionella, campilobacteria, comma bacillus, brucellas, meningococci, shigella, salmonella, klebsiella, colon Spectrum of action bacillus, mycobacteria of tuberculosis and leprosy, listeria, blue pus bacillus, intracellular microorganisms (chlamydia, mycoplasmas, ureaplasmas).

Infections of respiratory, urinary tracts, soft tissues, bones, joints; prostatitis, intestinal infections, gonorrhea, intra-abdominal infections, Indications chlamydiosis, ureaplasmosis, meningitis, sepsis, treatment of infections in oncologic patients.

Side effects Dysbacteriosis, allergic reactions, dysplasia of cartilagic tissue in children.

Ofloxacin shouldn’t be used together with antacids, iron-containing drugs. Norfloxacin is incompatible with cyclosporine. Enoxacin mustn’t be used together with oral indirect-acting anticoagulants. Doctor and pharmacist, Lomefloxacin is used, when mycobacteria of tuberculosis are resistant to antituberculous drugs. remember! Fluoroquinolones can increase photosensitivity of the tissues. Ciprofloxacin solution for intravenous injections mustn’t be mixed with solutions with pH more than 7. Sparfloxacin shouldn’t be used with cysaprid. After meals: 9. ANTIBIOTICS FROM DIFFERENT GROUPS

CHLORAM- PHOSPHO- LINCOSAMIDES FUSIDINES RIFAMPICINS POLYMYXINS OTHERS CLASSIFICATION PHENICOLS MYCINS 1. Lincomycin h/chl. 3. Fusidic 4. Chloramphenicol 7. Rifampicin 8. Phosphomycin 9. Polymyxin M 10.Spectino- (Neloren) acid (Levomycetin, (Phosphocin) sulfate mycin* (Cyrin) Drugs and their synonyms 2. (Fusidine) Ambophen) (Climycin) 5. Iruxol (comb.) 6. Syntomycin * - with aminocyclic structure, but it doesn’t cause toxic effects, that are characteristic for aminoglycosides. Inhibition of Inhibition of RNA Disruption of protein synthesis by function of the synthesis in formation of Inhibition of microbial cell Binding to bacterial ribosomes → inhibition of protein the microbial complex compound synthesis of the membranes by Mechanism of action synthesis. cell; with DNA- bacterial cell wall. change of disturbance of dependent RNA- superficial cation cell membrane polymerase. effect. integrity. Staphylococci (1-3,7,8), streptococci (1,2,4-8), gonococcus (3,10), blue pus bacillus (7,9), clostridia (1,2,4), causative agent of gas gangrene, Spectrum of action tetanus (1,2,5); bacteria of typhoid fever (4), diphtheria bacillus (1,2); colon bacillus, proteus, salmonellas (4,8,9); shigellas (4,9), legionella, tuberculosis mycobacteria (7); meningococcus (3,4,7), influenza bacillus (4,5,7,9), brucella (4,7,8), chlamydia, mycoplasma (4,5,7). Therapeutic effect: antibacterial (1-10). Pharmacological effects Side effects: dysbacteriosis (1-4,7-9), pseudomembranous colitis (1,2), hematotoxicity (4,5), hepatotoxicity (4), neurotoxicity (7,9), nephrotoxicity (9), allergic reactions (1-10). Gas gangrene, tetanus (1,2,5); anaerobic infections of abdominal cavity and pelvis minor (1,2,8), infections of skin, soft tissues, bones (1-3,5-6); Indications and meningitis (3,4,9), intestinal infections (1,4,9), meningococcus carriers sanation, tuberculosis (7); staphylococcal infections (1-3,6-8), interchangeability pseudomembranous colitis, osteomyelitis (3); infected wounds (3,5,6), gonorrhea (3,10), gonorrheal urethritis, cervicitis and proctitis (10), septicemia (1-3). Lincomycin is incompatible with ampicillin, carbenicillin, cephalothin, cephaloridin, canamycin. Clindamycin shouldn’t be used simultaneously with drugs, inhibiting intestinal peristalsis, neuromuscular transmission. Levomycetin is incompatible with glucose, hemopoiesis inhibitors, barbiturates, butamide, diphenine, neodicoumarine. Rifampicin is incompatible with oral anticoagulants, hypoglycemic drugs. Doctor and pharmacist, Rifampicin is inductor of liver microsomal enzymes, that’s why it stimulates metabolism of many drugs (cardiac glycosides, theophylline, glucocorticosteroids, contraceptives and others). remember! Phosphomycin potentiates antibacterial effect of -lactams and aminoglycosides. Lincomycin h/chl. mustn’t be injected with canamycin in one syringe. Clindamycin is incompatible with vitamins B, ampicillin, aminophylline, barbiturates, calcium gluconate, magnesium sulfate in one syringe. Rifampicin colors and saliva in red, phosphomycin – in orange. Before meals: 4,7. SULFONAMIDES (SULFANILAMIDES)

CLASSIFICATION MONOCOMPONENT SULFONAMIDES AGENTS, THAT ARE ABSORBED FROM INTESTINE SHORT-ACTING ONES LONG-ACTING ONES SUPERLONG-ACTING ONES 1. Sulfanilamide (Streptocide) 7. Sulfamethoxipyridazine (Sulfapyridazine) 10. Sulfamethoxipyrazine (Sulfalen, 2. Sulfathiazole (Norsulfazole) 8. Sulfamonomethoxine Kelphisine) 3. Sulfadimidine (Sulfadimesine) 9. Sulfadimethoxine (Madribon) 4. Sulfaethidole (Ethazole) Drugs and their synonyms 5. Sulfacarbamide (Urosulfan) 6. Sulfadiazine (Sulfazine) AGENTS, THAT ARE NOT ABSORBED FROM INTESTINE AGENTS FOR LOCAL USE 11. Phthalylsulfathiazole (Phthalazole) 14. Sulfacetamide (Sodium sulfacyl, Albucide) 12. Sulfaguanidine (Sulgine) 13. Phthalylsulfapyridazine (Phthazine)

Competitive antagonism with PABA (inhibition of PABA inclusion into folic acid synthesis): block of conversion of folic acid into dehydrofolic Mechanism of action acid (1-29).

Spectrum and type of Streptococci, staphylococci, pneumococci, meningococci, gonococci, colon bacillus; dysentery and typhoid fever causative agents; proteus, chlamydia, toxoplasma, etc. action Type of action: bacteriostatic (1-17,25,26,28,29), bactericidal (18-24,27).

Indications and Angina (1-4,7,9); bronchitis, pneumonia and others (2,4,7,9,10); pyelitis, cystitis, urethritis (4,5,7-10); cholecystitis (7-10); prostatitis, gonococcal urethritis (9); sepsis (2,3); meningitis (2,3,7,9); dysentery, enterocolitis (3,4,6,7,9,11-13); conjunctivitis, blepharitis (14); erysipelas interchangeability (1,4,9); purulent infection: wounds, burns, bedsores, trophic ulcers (10); malaria (6,7,9).

Sulfonamides are incompatible with hemopoiesis inhibitors (analgin, butadion, levomycetin, etc.), oral hypoglycemic drugs (sulfonylurea derivatives), PABA derivatives (novocaine), -, -adrenomimetics, salicylates, diphenine, PASA, folic acid, diuretics, methotrexate. Doctor and pharmacist, Streptocide is incompatible with digitoxin, isadrin, hydrochloric acid, caffeine, mesatone, phenobarbital, adrenaline h/chl. Norsulfazole is incompatible with novocaine, novocainamide, dicaine. remember! Sulfonamides often cause allergic reactions, dyspepsia, leukopenia, agranulocytosis. Sulfonamides in acidic medium of urine precipitate as crystals in urinary tract, that’s why voluminous alkaline drinking is prescribed during treatment with sulfonamides.

SULFONAMIDES (CONTINUATION)

CLASSIFICATION DERIVATIVES OF SULFONAMIDES SULFONAMIDES COMBINED AGENTS FOR EXTERNAL USE AND SALICYLIC ACID WITH TRIMETHOPRIM ONLY 15. Salazodine (Salazopyridazine) 18. Co-trimoxazole (Biseptol, Bactrim) 24. Silver sulfadiazine 27. Silver sulfathiazole 16. Salazodimethoxine 19. Lidaprim (Dermazine) (Argosulfan) Drugs and their synonyms 17. Salazosulfapyridine (Salazopyrine, 20. Sulfatone 25. Mafenide 28. Streptonitole Sulfasalazine) 21. Ditrim 26. Algimaf 29. Nitacide 22. Poteseptil 23. Potesetta Stability and effectiveness in medium, rich in PABA (25,26). + Mechanism of action Inhibition of → inhibition of Block of conversion of dehydrofolic acid Binding of Ag ions to DNA of microbial cell → prostaglandins synthesis (salicylates). into tetrahydrofolic acid (trimethoprim). inhibition of growth and replication of microorganisms (24,27).

Very broad spectrum (including majority of G+ and G- bacteria; Pneumocystis carini, Staph. Broad spectrum (G+ and G- bacteria; blue pus Spectrum of action aureus, Str. pyogenes, Diploc. pneum., Pr. vulgaris, E. coli, H. influenzae, etc.) (18-23). bacillus, gas gangrene causative agent, etc.).

Pharmacological effects Antibacterial (1-29), anti-inflammatory (15-17,28), immunomodulative (15-17), wound-purifying (24-27) effects.

Non-specific ulcerative colitis (15-17); angina, cholecystitis, meningitis, erysipelas (20); bronchitis, pneumonia (18-23); chronic non-specific Indications and pulmonary diseases (22,23); pyelitis, cystitis, urethritis, sepsis (18-21); gynecologic infections, dysentery, enterocolitis (19,20); prostatitis, interchangeability gonococcal urethritis (18-20); pyo-inflammatory processes in soft tissues: wound infection, burns, bedsores, trophic ulcers, fistulas, abscesses, phlegmons; , complicated by infection; pyodermatitis (20,24-29).

Doctor and pharmacist, One should avoid to prescribe poteseptil simultaneously with diphenine, salicylates, phenylbutazone, . Before meals: 7. remember! After meals: 15-18,22.

ANTITUBERCULOUS DRUGS

CLASSIFICATION IST LINE THERAPY (MAIN DRUGS) IIND LINE THERAPY (RESERVE DRUGS) ISONICOTINIC ACID PARA-AMINO- ANTIBIOTICS ISONICOTINIC ACID ANTIBIOTICS AND DRUGS HYDRAZIDE SALICYLIC ACID 7. Streptomycin THIOAMIDE FLUOROQUINOLONES* FROM DERIVATIVES (PASA) DERIVATIVES sulfate DERIVATIVES DIFFERENT 13. Cycloserine 8. Streptosaluzide 11. Ethionamide GROUPS 1. Isoniazide 5. PASA (Aminacyl) 14. Florimycin sulfate 9. Pasomycin 12. Prothionamide 2. Phthivazide 6. Calcium (Viomycin) 17. Ethambutol Drugs and their synonyms 10. Rifampicin 3. Opiniazide (Saluzide) benzamidosalicylate 15. Capreomycin sulfate (Combutol) (Rifampin) 4. Soluble saluzide (Bepasc) (Capastat) 18. Pyrazinamide 16. Lomefloxacin* (Pyzina) (Maxaquin) 19. Thioaceta- zone (Thibon) Formation of complex Competitive antagonism Inhibition of protein Binding to ions of Inhibition of synthesis of Inhibition of compounds with heavy with PASA → inhibition synthesis at the divalent metals, which mycobacterial cell wall mycobacterial metals ions, which are of mycobacteria growth ribosome level (7- are coenzymes → (13), proteins (14,15). RNA synthesis. Mechanism of action components of respiratory and reproduction. 9); inhibition of inhibition of Inhibition of the DNA- enzymes → inhibition of mycobacterial RNA mycobacteria growth. gyraze enzyme (16). mycobacteria breathing. synthesis (10). Pharmacological effect Antituberculous (1-19) effect: tuberculostatic (1-9,11-15,17-19), tuberculocidal (7,10,16). Indications and Different forms and locations of tuberculosis (1-19); leprosy (10,11,19); pulmonary forms of tuberculosis in case of inefficiency of the 1st line drugs (14- interchangeability 16); tuberculosis of mucous membranes, tuberculous lymphadenitis (19). Dyspepsia, allergic reactions (1-19); CNS disorders (1-4,7,8,13,14,16-18), hematologic disorders (5,10,18,19), gastrointestinal disorders (5,7,8,11,12), Side effects hepatotoxicity (10,18,19), ototoxicity (7-9,14).

Steptomycin is incompatible with muscle relaxants, glucose, vitamin B1, sodium thiosulfate, carbenicillin, erythromycin and other drugs with ototoxic effect. Rifampicin is incompatible with oral anticoagulants, oral hypoglycemic drugs, hormonal contraceptives, digitalis drugs, quinidine, glucocorticoids. Ethionamide is incompatible with cycloserine. Viomycin cannot be used together with ototoxic antibiotics. Doctor and pharmacist, Capreomycin cannot be used together with parenteral antituberculous drugs. remember! PASA is incompatible with sulfonamides. Rifampicin colors sputum, lacrimal liquid, urine in red; it is inductor of liver microsomal enzymes. Ethambutol, PASA can be used by pregnants. Effectiveness of antituberculous drugs: Rifampicin> Streptomycin sulfate>Pyrazinamide> Ethionamide=Prothionamide> Ethambutol> Cycloserine> >Viomycin> PASA> Thioacetazone. Before meals: 10,13. After meals: 1,5,18,19.

ANTIHELMINTHIC DRUGS

DRUGS FOR TREATMENT DRUGS FOR TREATMENT INTESTINAL DRUGS FOR TREATMENT CLASSIFICATION EXTRAINTESTINAL NEMATODOSES INTESTINAL CESTODOSES HELMINTHIASES

1. adipinate 10. Niclosamide (Fenasal) 13. Ditrazine citrate (Loxuran) 2. Bephynite hydroxynaphthaate (Naphthamon) 11. Aminoacrichine 14. Praziquantel (Biltricide) 3. Thiabendazole (Menodel) 12. Pumpkin seeds 4. Mebendazole (Vermox) Drugs and their synonyms 5. (Combantrin) 6. Pyrvinium pamoate (Vanquin) 7. Levamizole (Decaris) 8. Tansy flowers 9. Levant wormwood flowers

Disruption of neuromuscular system functions in nematodes (1-3,5,7,13); irreversible disturbance of glucose utilization by helminths (4); paralysis of Mechanism of action neuromuscular system in cestodes, destruction of their covering tissues (10,12,14); influence on the helminths’ energy processes (6-9,11).

Pharmacological effects Antihelminthic (1-14), immunostimulative (7) effects.

Indications and Ascariasis (1,2,5,7-9,13); enterobiasis (1-6,8); trichocephaliasis (2-5); ancylostomiasis (2,4,7); teniasis (4,10-12,14); diphyllobothriasis, interchangeability hymenolepiasis (10-12,14); filariasis (13); schistosomiasis, trematodoses (14).

Ditrazine citrate shouldn’t be used simultaneously with steroid agents. Doctor and pharmacist, Mebendazole is incompatible with levamizole. Pyrantel is incompatible with piperazine. remember! Before meals: 2,9-12. After meals: 3,5,6.

ANTIFUNGAL DRUGS

ANTIFUNGAL CLASSIFICATION SYNTHETIC ANTIFUNGAL DRUGS ANTIBIOTICS POLYENE ONES* AND AZOLES ALLYLAMINES, DERIVATIVES OF AGENTS FROM OTHER OTHERS 8. (Canesten) PYRIMIDINES*, UNDECYLENIC CHEMICAL GROUPS 9. (Nisoral) NITROPHENOLS** ACID 1. Amphotericin B* 26. Cyclopyroxolamine 10. Myconazole (Dactarine) 19. Terbinafin (Lamisil) (Fungisone) 23. Undecin (Batrafen) 11. Econazole (Pevaril) 20. Naftifin (Exoderil) 2. Amphoglucamine 24. Zincundan 27. Amorolfin (Loceril) 12. Isoconazole (Travogen) 21. Flucytosin*(Ancotyl) 3. Nystatin* 25. Mycoseptin 28. Tolcyclate Drugs and their synonyms 13. Bifonazole (Mycospor) 22. Chlornitrophenol** 4. Levorin* (Tolmycen) 14. Fluconazole (Diflucan) (Nitrofungin) 5. Natamycin COMBINED DRUGS 29. Tolnaphthate 15. (Orungal) (Pimafucin) (Chinofungin) 16. Tenonitrazole (Atrican) 31. Clion D 6. Griseofulvin 30. Dequalinyl 17. Thioconazole (Vagistat) 32.Mycozolone 7. Mycoheptin* (Decamine) 18. Flutrimazole (Mycetal) 33.Canderm-BG Inhibition of basic enzymes of ergosterol (the main structural component of fungal cell wall) synthesis: squalylepoxidase (19,20,28,29), 14-reductase and 7-8- isomerase (27), cytochrome P-450-dependent enzymes (only of the fungi) (8-18, 31-33). Binding to sterols of cell membranes → increase of their permeability → Mechanism of action destruction of fungal cells (1-5,7,23-25,30). Inhibition of nucleic acids synthesis and fungal cells reproduction (6,21). Block of aminoacids, phosphates, calcium ions transport through the fungal cell membranes (26).

Pharmacological effects Antifungal (1-33): fungicidal (1-5,7-21,23-28,30-33), fungistatic (6,8-33); antibacterial (4,8-18,20,22,26,30-33) effects.

Systemic mycoses: candidosis (1-5,7,8-18), favus (5,6,9,19,20), cryptococcosis (1,2,7,14,15,21), histoplasmosis (1,2,7,9,14,15,19,26), blastomycosis (1,2,9,14, Indications and 15,19,26), aspergillosis (1,2,7,14,15,26), paracoccidioidomycosis (7,9,15,20,26,27), trichomoniasis (4,31). interchangeability Local mycoses: candidosis (1-7,8-18,31-33); trichophytosis, microsporosis, epidermophytosis (6,8-20,22,23-25,26-33); onychomycosis (5,6,9,13-20,26,27), trichomycosis (6,9,19,31), eye mycosis (9,15), mouth mycosis (9,14,30), otomycosis (5,11).

Clotrimazole is used only for local applications. It is effective against streptococci, staphylococci, bacteroides and trichomonades. Ketoconazole is incompatible with antiulcer drugs (antacids, cholinolytics, H2-histaminoblockers) because they decrease the acidity and its absorption. It is also incompatible with terfenadine, astemisole, prednisolone, lovastatin. Batrafen penetrates through the cornea. Doctor and pharmacist, Nystatin is incompatible with glucose. remember! Fluconazole, itraconazole, ketoconazole should be carefully prescribed for patients with liver dysfunction. Itraconazole mustn’t be used together with indirect-acting anticoagulants, calcium antagonists, quinidine, vincristin, rifampicin, phenitoin, midazolam, triazolam, astemisole, terfenadine, cisaprid. After meals: 2,15. During meals: 6,9.

ANTIVIRAL DRUGS

HIV-PROTEINASE ADAMANTAN ABNORMAL PYROPHOSPHATE INTERFERONS’ AND REVERSE DERIVATIVES INTERFERONS CLASSIFICATION ANALOGUES INDUCTORS TRANSCRIPTASE* AND OTHERS* INHIBITORS 1. Acyclovir (Zovirax, 5. 8. Sodium foscarnet 9. Interferon- 12. Cycloferon 14. Saquinavir Herpevir) 6. Amantadine (Triapten) (Egyferon) (Neovir, (Invirase) 2. Ribavirin (Virasol) 7. Oxolin* 10. Interferon 2 Camedone) 15. Didanosine* Drugs and their synonyms 3. Ganciclovir (Reaferon) 13. Amixin (Videx) (Cimeven) 11. Interferon- -2 16. Zidovudine* 4. Famciclovir (Famvir) (Intron A) (Retrovir, Azydotimidine) Stimulation of Block of HIV- Suppression of Block of synthesis of synthesis of Inhibition of viral DNA Inhibition of viral proteinase (14), viral RNA specific viral endogenous Mechanism of action and RNA synthesis. DNA-polymerase. reverse transcriptase transcription. proteins. interferon in human (15,16). organism. Specific antiviral Antiviral, immunostimulative, antitumor (9- Antiviral (1-8), immunostimulative (1-2) effects. effect against HIV- Pharmacological effects 13) effects. infection (14-16). Prophylaxis and Prophylaxis and treatment of treatment of Viral hepatitis (A, Herpes (simplex, zoster), influenza A (5-7), influenza (9,11); B), herpes, acute cytomegalovirus herpes, adenovirus hepatitis, viral respiratory Indications and infections (1-4); keratoconjunctivi- cytomegalovirus, Herpes (8). diseases, HIV-infection (14-16). influenza A, B, tis, papillomatosis, herpes infection; viral interchangeability encephalomyelitis, chickenpox, respiratory molluscum pneumonia, HIV- chlamydiosis (12, syncytial infections (2). contagiosum (7); infection, Kaposi's 13). tick-borne sarcoma (9-11); encephalitis (5). myeloleukemia (11). Ganciclovir is incompatible with imipenem-cilastatin. Interferon-2 is not recommended to use together with NSAIDs and glucocorticosteroids. Rimantadine is used for prophylaxis and early treatment of influenza in epidemic period. Doctor and pharmacist, Only 0,25% and 0,5% oxolin ointment is used in ophthalmology. remember! It is recommended to begin treatment in early stages of disease, while using sodium foscarnet. Interferon- -2 shouldn’t be prescribed to patients with mental disorders in anamnesis. Interferons mustn’t be prescribed in case of kidneys functions disorders. After meals: 13, 14.

ANTIMALARIAL DRUGS

DRUGS, AFFECTING THE SCHIZOGONY (AGAMIC CYCLE OF DRUGS, AFFECTING THE DEVELOPMENT IN THE HUMAN ORGANISM) SPOROGONY (GENITAL CYCLE OF DEVELOPMENT IN CLASSIFICATION TISSUE CYCLE (LIVER) BLOOD CYCLE THE MOSQUITO ORGANISM) COMBINED DRUGS (ERYTHROCYTE) SCHIZOTROPIC ONES GAMONTOTROPIC ONES HISTOSCHIZOTROPIC: HEMATOSCHIZOTROPIC 1. Pyrimethamine 9. Pyrimethamine + 1. Pyrimethamine (Chloridine) 1. Pyrimethamine 2. Proquanyl h/chl. sulfamethapyrazine 2. Proquanyl h/chl. (Bigumal) 2. Proquanyl h/chl. 3. Quinocide (Methakelfine) 3. Quinocide 5. Chloroquine (Delagyl) 4. Primaquine 10. Pyrimethamine + sulfadoxin Drugs and their synonyms 4. Primaquine (Primachine) 6. (Fansidar) 7. Hydroxychloroquine (Plaquenyl) 8. (Lariam)

Pharmacological effect Antiprotozoal (1-10): parasitocidal (3-7,9-10), parasitostatic (1-2) effect.

Indications and Treatment of acute manifestations of malaria (1,2,5,7-9), treatment of malaria, resistant to chloroquine and other antimalarial drugs (6,10); prophylaxis of early malarial recidivations (1,2), prophylaxis of late malarial recidivations (3,4), public antimalarial prophylaxis (1,2,4,5,7,8), interchangeability individual chemoprophylaxis in combination with chloroquine (4), leishmaniasis and toxoplasmosis treatment (1). Treatment of collagenoses (systemic lupus erythematosus, rheumatoid arthritis) (5,7), arrhythmias (extrasystole, fibrillation, etc.) (5,6).

All antimalarial drugs are very toxic. Quinocide mustn’t be prescribed with other antimalarial drugs simultaneously. Primaquine shouldn’t be used with acrichine and sulfonamides. Chloroquine mustn’t be combined with sulfonamides, salicylates, glucocorticosteroids. Doctor and pharmacist, Pyrimethamine is antagonist of folic acid, disturbs its metabolism in the human organism, causes megaloblastic anemia. remember! Pyremethamine is excreted with mother’s milk and prevents malaria in newborns. Quinocide, primaquine, quinine cause acute intravascular hemolysis with hemoglobinureal fever among patients with congenital insufficiency of glucose-6-phosphate dehydrogenase in erythrocytes. Mefloquine has teratogenic effect: during all period of treatment and two months after it women in reproductive age should use contraceptives. After meals: 2,3,5.

ANTISYPHILITIC DRUGS

ANTIBIOTICS BISMUTH ARSENIC CLASSIFICATION MACROLIDES IODINE DRUGS PENICILLINS CEPHALOSPORINS AND DRUGS DRUGS AZALIDES* 1. Benzylpenicillins 5. Cephaloridine 6. Erythromycin 8. Biyoquinol 10. Miarsenol 12. Potassium 2. Benzatine benzylpenicillin (Ceporine) 7. Azithromycin* 9. Bismoverol 11. Osarsol iodide Drugs and their synonyms (Extencillin, Bicillin-1) (Sumamed) (Acetarsol) 13. Sodium iodide 3. Phenoxymethylpenicillin 4. Oxacillin (Prostaphlin) Inhibition of synthesis of the bacterial cell wall (1-5); disruption of protein Block of sulfhydryl (thiol) groups in the Mechanism of action synthesis in the bacterial cell (6-7). enzymatic systems of spirochetes.

Pharmacological effects Antispirochetal (1-11), antiprotozoal (11), anti-inflammatory (8-9), decompositing (8,12-13) effects.

The 3rd stage of syphilis (10,11), treatment The 3rd stage of Indications and of different forms of syphilis in combination syphilis: gummas All stages of syphilis (1-4). Syphilis, resistant to penicillins (5-7). with penicillins (8,9); penicillin-resistant decomposition interchangeability forms of syphilis, syphilis in patients with (12,13); optic nerve intolerance of the penicillins (8-11). affection (13).

Penicillins are incompatible with macrolides, adrenaline, -globulin, glucose, potassium iodide, vitamins C, P, K, B1, B12; streptomycin, anticoagulants, levomycetin. Oxacillin is incompatible with the bacteriostatic antibiotics. Solutions of benzylpenicillin sodium and potassium salts and timentine are incompatible with other drugs in one syringe. Erythromycin is not recommended to prescribe with acetylcystein, lincomycin, methylxanthines simultaneously. Doctor and pharmacist, Potassium iodide is incompatible with papaverin h/chl. remember! Drugs of bismuth and arsenic are toxic; they cause gingivitis, stomatitis, grey line at the gum border. Miarsenol causes jaundice, hepatitis and polyneuritis. Osarsol has also trichomonadocidal and amebocidal effects. Extencillin is only for intramuscular injection. Before meals: 7,11. After meals: 6,12.

ANTISEPTICS AND DISINFECTANTS

CLASSIFICATION HALOIDS OXIDANTS ACIDS AND ALKALIES HEAVY METALS SALTS 1. Chloramine B 8. peroxide concentrated 11. Salicylic acid 16. dichloride (Sulema) 2. Disodium monolasone solution (Perhydrol) 12. 17. Silver nitrate (Pantocide) 9. Potassium permanganate 13. Boric acid 18. Silver protein (Protargol) 3. Chlorhexidine 10. Benzoyl peroxide (Oxy 5, 10) 14. (Skinoren) 19. Zinc sulfate Drugs and their synonyms 4. Triiodomethan (Iodoform) 15. Sodium tetraborate (Borax) 5. Povidon-iodine (Betadine) 6. Iodine (lodinol, lodonat) 7. Iodopyrone

Protein denaturation, block of Halogenative and oxidative effect Disruption of oxidation-reduction sulfhydryl groups of on microbial cell (protein processes of protoplasmic proteins Denaturation of the protoplasmic protoplasmic enzymatic systems Mechanism of action denaturation and oxidation of and enzymatic systems in proteins in microbial cell. in the microbial cell; formation enzymes). microbial cell. of albuminates.

Pharmacological effects Antiseptic, antibacterial (1-58); keratolytic (10,11,14); astringent, anti-inflammatory (17-19); antipedicular (13); adsorbing (58) effects.

Water disinfection (2); hands disinfection (1-3,5,7); disinfection of instruments (1,3,5,16); disinfection of goods for medical care, apartments Indications and (1,16); disinfection of operative site (3,5-7); gastric lavage after intoxication (9), various skin diseases (externally: treatment of infected wounds, burns, ulcers, bedsores, erysipelas, eczema, etc.) (1-5,7-13,15,17); prophylaxis and treatment of oral cavity and nasopharynx infections (8,9,17- interchangeability 19), chronic otitis (13), conjunctivitis (13,17-19); syringing, rinsing, lavage in surgery, gynecology, urology, dentistry (8,9,15,18,19); acne (10,14).

Chlorhexidine is incompatible with iodine-containing drugs. Povidon-iodine mustn’t be used in complex with enzymatic ointments. Silver nitrate solution must be prepared only before use. Doctor and pharmacist, 0,1-0,2% potassium permanganate solution is used for gastric lavages in case of morphine, phosphorus intoxications. It isn’t effective in case of remember! atropine, , intoxications. While working with mercury dichloride solution, one has to be careful. Mercury drugs are very toxic. 1% solution is to cyanide, carbon oxide, hydrogen sulfide. In small doses (1% solution – 0,1 ml per 1 kg of body weight) it’s used for treatment intoxications by methemoglobin-forming poisons (nitrates, aniline and others).

ANTISEPTICS AND DISINFECTANTS (CONTINUATION) DERIVA- ANTIBAC- NITRO- TIVES OF 8- ALDEHYDES TARS AND TERIAL DYES DETERGENTS CLASSIFICATION FURANS OXY- AND RESINS NATURAL DRUGS 20. (carbolic 27. Methylene 30. Nitrofural 36. Quinozole 39. 43. Cerigel 49. Ichthammol 52. Sodium acid) blue (Furacilin) 37. Quiniophone solution 44. Ethonium (Ichthyol) usninate 21. Tricresol 28. Brilliant 31. Furaplast 38. Nitroxoline (Formalin) 45. Roccal 50. Vinisol 53. Novoimanin 22. Resorcin green 32. Lifusol (5-NOC) 40. Lysoform 46. Green soap 51. Cigerol 54. Chloro- 23. Phenylsalicylate 29. Aethacri- 33. Furazolidone 41. Hexamethylen 47. Decame- phyllipt Drugs and their synonyms (Salol) dine lactate 34. Furasidin tetramine thoxin 55. Ectericide 24. Polycresulen (Rivanol) (Furagin) (Urotropine) (Septephril) 56. Baliz - 2 (Vagotyl) 35. Nifuratel 42. Ethanol 48. Miramistin 57. Eucalimin 25. Benzonaphthol (Macmiror) 58. Polyphepan 26. Feresol Reduction of Inhibition of Inhibition of nitro-group protein Decrease of Block of enzymatic into amino- synthesis, surface Block of enzymatic enzymatic Bacteriostatic and bactericidal processes, group, formation of tension, activity of activity of activity as a result of complex formation of disruption of metal chelates disruption of Mechanism of action dehydrogenases, dehydrogenases, influence of bioactive insoluble DNA function, → increase of the microbial protein denaturation. protein substances. complex inhibition of oxidative cell wall denaturation. substances. bacterial cell processes in permeability. respiration. protoplasm.

Disinfection of hands (36,39,40,42,43,45,46); disinfection of instruments (20,21,39,42,45); disinfection of goods for medical care (20,21,45); disinfection of apartments (20,21,40,45); disinfection of operative site (45); infectious intestinal diseases (23,25,30,33,37,54,58); various skin Indications and diseases (externally: treatment of infected wounds, burns, ulcers, bedsores, erysipelas, eczema, etc.) (22,24,27,28,32,34,36,37,44,48,49,57); prophylaxis and treatment of oral cavity and nasopharynx infections (29,47,53,54,57); inhalations in case of infectious-inflammatory diseases of interchangeability respiratory tract (34,53,54,57); urinary tract infections (23,34,35); syringing, rinsing, lavage in surgery, gynecology, urology, dentistry (24,27,29,30,34-36,37,40,53,57); as preservatives in pharmaceutical industry (20,21,42); cervical erosions (54), eye diseases (30,41), conjunctivitis (29,30,34), disinsection (20), removal of papillomas, warts, corns (26); amebic dysentery, ulcerative colitis (37).

Doctor and pharmacist, Before meals: 58. remember! After meals: 33,34.

ANTIALLERGIC DRUGS

SELECTIVE MEMBRANE ANTAGONISTS OF HISTAMINE AND SEROTONIN* STABILIZERS AND GLUCOCORTICO- CLASSIFICATION LEUKOTRIENE RECEPTORS BLOCKERS ANTITRANSMITTER* STEROIDS D -RECEPTORS, AGENTS 4 COMBINED* DRUGS 1. (Tinset) 7. 13. Sodium cromolyn (Intal) 16. Prednisolone 22. (Acolat) 2. (Suprastin) 14. Ketotifen (Zaditen) (Depersolone) 23. Montelukast (Singular) (Allergodil) 8. Mebhydroline 15. Fenspirid* (Erespal) 17. Budesonid (Pulmicort) 24. Clarinase* 3. (Claritin) (Diazoline) 18. Hydrocortisone butyrate 25. Coldrex night* Drugs and their 4. Terfenadine (Trexil) 9. (Tavegil) (Laticort) 5. 10. (Fencarol) 19. Triamcinolone acetonide synonyms (Pipolphen) 11. Ciproheptadine* (Fluorocort) 6. (Peritol) 20. Momethasone furoate (Dimedrol) 12. (Nasonex) (Dedalone) 21. Dexamethasone (Fortecortin)

Block of histamine receptors: H1 (1-4,8,14,24), H1 and H2 (5-7,9-12,25); block of serotonin receptors (11), stabilization of mast cells’ membranes Mechanism of action (1,13,14), block of histamine and serotonin receptors, inhibition of cytokines production (11,15); inhibition of immune reactions, decrease of histamine release and antibodies production (16-21); selective block of leukotriene D4-receptors (22,23). Antiallergic effect (1-25); decrease of bronchial smooth muscles spasm and capillaries’ permeability (1-11,13-21,23); sedative (1,5- Pharmacological effects 7,9,11,14,15,25), antiemetic (12), anti-inflammatory (5,6,13,14,16-22,25), immunosuppressive (16-21), potentiative (5-7,11) effects.

Indications and Anaphylactic shock, angioneurotic edema (3,4,7,10,11,16-19,21); bronchial asthma (1,3,4,7,13-19,21-23); urticaria, allergic dermatitis, rhinitis, interchangeability pollinosis (1-14,16-21,24); rheumatism, systemic lupus erythematosus (15-20); motion sickness (5,12), acute viral respiratory infections (25).

Antihistaminic drugs are incompatible with anticoagulants, promedol, emetics, M-cholinomimetics, tricyclic antidepressants, streptomycin, neomycin, canamycin. Oxatomide, diphenhydramine, chloropyramine, ciproheptadine, fenspirid are not recommended to use simultaneously with barbiturates, hypnotics, sedatives, opioid analgesics, tranquilizers. Doctor and pharmacist, Terfenadine, loratadine mustn’t be simultaneously used with ketoconazole, itraconazole, erythromycin, cimetidine. remember! Diphenhydramine is incompatible with vitamin C, sodium bromide, gentamycin. Chloropyramine, coldrex night mustn’t be combined with tricyclic antidepressants. Intal solution shouldn’t be inhalated in mixture with h/chl. and ambroxol h/chl. solutions. Treatment of patients with bronchial asthma and obstructive bronchitis with ketotifen should be stopped gradually. Before meals: 12,15,22. After meals: 8,10,11. During meals: 7,14. DRUGS FOR TRANSFUSIONAL THERAPY

DRUGS FOR DRUGS FOR ACIDOSIS DRUGS FOR CLASSIFICATION PLASMA SUBSTITUTES REHYDRATION AND CORRECTION PARENTERAL FEEDING DETOXICATION 1. Albumin 5. Dextrose (Glucose) 11. Trometamol 13. Aminosteril 2. Dextran (Polyglucin, 6. Fructose (Levulose) 12. Sodium hydrocarbonate 14. Aminosol Reopolyglucin) 7. Polyvidone (Neohemodes) 15. Aminoped Drugs and their synonyms 3. Hydroxyethylated starch 8. Sodium chloride 16. Lipofundin MCT/LCT (Refortan) 9. Disalt 4. Gelatin 10. Ionosteril

Restoration of volume of circulating blood; support of the colloid-osmotic , Decrease of intoxication effects, Decrease of acidosis effects, The sources of aminoacids (13- Pharmacological effects increase of blood pressure, normalization of hemodynamics. stabilization of acid-base balance. 15), fatty acids (16). improvement of the rheologic properties of blood.

Indications and Collapse, shock (1-7); metabolic acidosis (11,12); detoxicative infusion therapy, acute loss of blood (1-8); toxicosis of pregnancy (7); parenteral feeding of children (15) and adults (13,14,16); protein loss after surgeries, burns (1,13,14); dissolution of drugs (5,6,8); of various interchangeability genesis (diarrhea, vomiting, food infection) (9,10).

Glucose is incompatible with levomycetin, streptomycin. Doctor and pharmacist, Dextran should not be infused in case of cerebral hemorrhage, skull injuries, increase of intracranial pressure. Albumin should not be infused in case of dehydration, thrombosis, arterial hypertension. remember! Lipofundin must not be used by patients with ketoacidosis, adipose nephrosis, shock. When intravenous infusion of polyvidone is impossible, its subcutaneous infusion is permitted.